Diagnostic Ultrasound - Abdomen and Pelvis

Crohn Disease
(Left) Long-axis ultrasound of
the terminal ileum shows
thickening of the bowel wall.
Although a long segment of
bowel was thickened, note the
focal area of decreased
echogenicity and loss of bowel
wall stratification indicative of
severe subacute inflammation
ſt. (Right) Grayscale
ultrasound shows a markedly
thickened and diffusely
hypoechoic terminal ileum st
with loss of the normal bowel
wall stratification. Small
bubbles of gas are also seen
within the bowel wall
consistent with an area of
ulceration ſt.
Diagnoses: Bowel
(Left) Short-axis ultrasound of
the terminal ileum in the same
patient shows the marked
thickening of the bowel wall
and loss of normal
stratification st. The irregular
and spiculated serosal border
ſt of the wall is indicative of
severe transmural
inflammation. (Right) A
panoramic view of the
terminal ileum in the same
patient shows the markedly
thickened terminal ileum with
resultant narrowing of the
lumen ſt. There is dilation of
the more proximal, upstream,
ileum reflecting some degree
of obstruction .
(Left) Grayscale ultrasound
shows thickened bowel loops
. There is thickening and
increased echogenicity of the
surrounding mesentery ſt.
(Right) Long-axis US shows a
thickened loop of sigmoid
colon ſt. There is increased
echogenicity of the adjacent
mesentery with hyperemia of
the vasa recta correlating
to the "comb" sign on CTE or
MRE.
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