الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Crohn’s disease is a serious chronic condition belonging to inflammatory bowel disease which is characterized by transmural inflammation of the gastrointestinal tract. The transmural inflammation often leads to fibrosis and to obstructive clinical presentations.
Approximately 80 % of CD patients have small bowel involvement, usually in the distal ileum, with one-third of patients having exclusively ileitis.
The etiology and pathogenesis of IBD remains unclear, but it seems to be multifactorial; a triggering environmental factor leads to abnormal immune response in a genetically predisposed person.
Activity of IBD is measured by using clinical, endoscopic, histological, and radiological activity indices.
Ultrasonography is useful in documenting the length and location of strictures in Crohn’s disease and especially when the disease involving segments of the gastrointestinal tract not accessible by colonoscopy.
So the aim of the present study was to evaluate the role of ultrasound in the evaluation of Crohn’s disease.
The present study included fifty patients; 42 males and 8 females. All patients had CD. They were divided into three groups according to the activity of the disease in which group I included 10 patients diagnosed with mild activity, group II included 20 patients diagnosed with moderate activity and group III included 20 patients diagnosed with severe activity who were subjected to history taking and clinical examination, routine laboratory investigation (CBC, renal function, liver function, serum albumin, ESR, CRP), CDAI, SES-CD, radiological investigation (Multislice CT Enterocolonography, ultrasound of abdomen with Doppler mapping).
Abdominal pain and diarrhea were the predominant presentation, arthralgia was the predominant extraintestinal presentation.
Laboratory tests showed that the mean hemoglobin value in the three groups clustered around 10.73±2.32 with a significant difference between the three groups. ESR and CRP showed high level with a significant difference between the three groups.
In the present study, we found that fecal calprotectin mean value in the three groups was 527.92 ± 371.017 with a significant difference between the three groups.
In the present study regarding Crohn’s disease activity index mean level in the three groups was 416.46 ± 213.257, moreover as regards Simple Endoscopic Score for Crohn’s Disease (SES-CD) the mean score for the three groups was 24.952 ± 14.5553 with a significant difference between the three groups.
According to our study, we found that high resolution ultrasound of the abdomen with doppler mapping had a role in evaluate activity of crohn’s disease, and in our study, we evaluated the correlation of high resolution ultrasound of the abdomen to the gold standered diagnostic tool multislice CT enterocolonography.
It was found that high resolution ultrasound can identify the complications of crohn’s disease such as abscess, fistula and stricture.
It was found that the sensitivity of CT enterocolonograph was 85.0%, specificity was 90.0%, accuracy was 88.5%, positive predictive value was 90.0% and negative predictive value was 86.0%.
In the present study, we found that the U/S sensitivity was 90.0%, specificity was 95.0%, accuracy was 92.0%, positive predictive value was 92.0% and finally negative predictive value was 88.0%.
Ultrasound findings in crohn’s patients was found to be positively correlated with WBCs count, ESR, CRP, fecal calprotectin, CDAI and SES-CD, while it was found to be negatively correlated with the serum albumin.