HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ripollés, T. Articles by Errando, J. Search for Related Content PubMed PubMed Citation Articles by Ripollés, T. Articles by Errando, J. Social Bookmarking                      What's this? Hotlight (NEW!) What's Hotlight?

Appendiceal Involvement in Crohn's Disease: Gray-Scale Sonography and Color Doppler Flow Features

¹ All authors: Department of Radiology, Hospital Universitario Dr. Peset, 90 Gaspar Aguilar Ave., Valencia 46017, Spain.

OBJECTIVE. The objective of our study was to evaluate appendiceal involvement in Crohn's disease with gray-scale and color Doppler sonography and differentiate it from acute appendicitis.

MATERIALS AND METHODS. Analysis of the sonographic examinations was performed over 5 years in 190 patients with an established diagnosis of Crohn's disease. Data analyzed were as follows: visualization of the appendix; thickness and color Doppler signal (grade 0, 1, or 2) of the appendix and adjacent intestinal loop (cecum, terminal ileum, or both); involvement of other intestinal segments; and abscesses. The findings were compared with those of 49 consecutive patients with sonographic findings of acute appendicitis.

RESULTS. Thirty-nine patients with Crohn's disease (21%) had appendicular involvement. All but one patient showed thickening of the terminal ileum, and 46% of patients also showed thickening of the cecum. The thickness of the ileum was more than 5 mm (only the anterior wall) in 64% of patients. Appendicular hyperemia was seen in 72% of patients. Involvement of other segments was seen in 23 patients (59%) and adjacent abscesses in six (15%). Irregular thickness of the submucosa was seen in nine cases (23%) and fibrofatty proliferation in 19 (49%). In patients with ileocecal regional disease, ileum thickness of more than 5 mm and visible color in the ileum were the most valuable signs, both for the diagnosis of Crohn's disease and to differentiate it from acute appendicitis (positive predictive value, 96%; negative predictive value, 74%).

CONCLUSION. Appendicular involvement in Crohn's disease is a relatively frequent event (21%). Sonography and color Doppler sonography may be useful for differentiating Crohn's disease with appendicular involvement from acute appendicitis.

Keywords: appendicitis • appendix • Crohn's disease • Doppler studies • sonography

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				S. Kuzmich, D. C. Howlett, A. Andi, D. Shah, and T. Kuzmich Transabdominal Sonography in Assessment of the Bowel in Adults Am. J. Roentgenol., January 1, 2009; 192(1): 197 - 212. [Abstract] [Full Text] [PDF]

				J. E. Jacobs CT and Sonography for Suspected Acute Appendicitis: A Commentary. Am. J. Roentgenol., April 1, 2006; 186(4): 1094 - 1096. [Full Text] [PDF]