Diagnostic Ultrasound - Abdomen and Pelvis

Crohn Disease
(Left) Long-axis ultrasound
shows a markedly thickened
terminal ileum ſt. Note that
even though thickened, there
is preservation of some of the
mural stratification seen in
normal bowel. Echogenic
submucosa is present and
thought to be related to
lymphedema. (Right) Long-axis
ultrasound of the transverse
colon shows mild thickening of
the wall with some loss of the
normal stratified appearance
of the bowel wall ſt. The
aorta and vena cava are
noted.
Diagnoses: Bowel
(Left) Color Doppler US of the
terminal ileum shows bowel
wall thickening st and
hyperemia, which is
compatible with acute
inflammation. (Right) Color
Doppler US from the same
patient after treatment shows
continued wall thickening st
but markedly reduced color
Doppler blood flow consistent
with interval decrease in
active inflammation.
(Left) Long-axis ultrasound of
the rectum using the bladder
as a window shows thickening
of the rectum ſt. Color
Doppler ultrasound at the
same location shows
hyperemia of the thickened
wall. (Right) Long-axis
ultrasound shows thickening
and loss of bowel wall
stratification in the terminal
ileum. Additionally, there is an
inflammatory polyp ſt
protruding into the lumen.
These polyps can form in the
healing phase of extensive
ulcerative disease.
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