The diagnostic significance of bowel wall thickening for inflammatory bowel disease Barsak Duvar Kalinlaşmasinin İnflamatuar Barsak Hastaliǧi İcin Tanisal Onemi


Akbulut U. E., Saǧ E., ÇAKIR M.

Turkiye Klinikleri Pediatri, vol.25, no.1, pp.23-27, 2016 (Scopus) identifier

  • Publication Type: Article / Article
  • Volume: 25 Issue: 1
  • Publication Date: 2016
  • Doi Number: 10.5336/pediatr.2015-47639
  • Journal Name: Turkiye Klinikleri Pediatri
  • Journal Indexes: Scopus
  • Page Numbers: pp.23-27
  • Keywords: Child, Inflammatory bowel diseases, Tomography
  • Istanbul University Affiliated: No

Abstract

Copyright © 2016 by Tür kiye Klinikleri.Objective:We aimed to investigate the diagnostic significance of bowel wall thickening (BWT) in abdominal computed tomography (ACT) imaging in combination with clinical and laboratory parameters for inflammatory bowel disease (IBD). Material and Methods: The study included the patients admitted to our clinic with both chronic abdominal symptoms and performed colonoscopy and ACT since 2008. Age and gender of the patients, hematological parameters [hemoglobin level, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), albumin, and platelet count], site of BWT (terminal ileum, entire colon and recto-sigmoid), accompanying pathologies [lymphadenopathy (LAP), fistula] and final diagnoses were recorded from the file reports. Subjects with BWT were divided into subgroups, with or without IBD, and compared. Results: 109 (54.1% female, mean age 10.44±4.14 years) children were included in the study. BWT was determined in 31 (28.4%) patients (67.7% female, mean±SD age 12.36±3.68). BWT was located at the terminal ileum in 11 (35.5%), at the colon in 9 (29.0%) and at the recto-sigmoid region in 11 (35.5%) patients. There was pathologic LAP in nine (29.0%), internal fistula in 1 (3.2%) and intraabdominal fluid in 2 (6.4%) patients. Ultimately, 15 (48.4%) patients were diagnosed as having IBD, 6 (19.4%) non-specific colitis and 4 (12.9%) with other diseases. No etiological factor was found with BWT in 6 (19.4%) patients. Significant difference was found in ESR (p=0.02) and platelet count (p=0.0001) in patients with both BWT and IBD (n=15) compared with the other patients (n=16). Conclusions: Inflammatory bowel disease must be in differential diagnoses in children with chronic abdominal symptoms and BWT combined with high ESR and platelet count and advanced evaluations performed for the diagnoses.