Endoscopic Ultrasonography versus Computed Tomography in the Differential Diagnosis of Perianorectal Complications in Crohn's Disease

A. U. Schratter-Sehn; H. Lochs; H. Vogelsang; H. Schurawitzki; C. Herold; M. Schratter

doi:10.1055/s-2007-1010409

Endoscopy, Table of Contents

Endoscopy 1993; 25(9): 582-586
DOI: 10.1055/s-2007-1010409

Endoscopic Ultrasonography versus Computed Tomography in the Differential Diagnosis of Perianorectal Complications in Crohn's Disease

A. U. Schratter-Sehn¹ , H. Lochs² , H. Vogelsang² , H. Schurawitzki³ , C. Herold³ , M. Schratter³

¹Department of Radiotherapy and Radiobiology, School of Medicine, University of Vienna, Austria
²Department of Gastroenterology and Hepatology, School of Medicine, University of Vienna, Austria
³Department of Diagnostic Radiology, School of Medicine, University of Vienna, Austria

Abstract

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Abstract

In this prospective study the performance of transrectal or transvaginal endoscopic ultrasonography (EUS) was compared with that of computed tomography (CT) in the diagnosis of perirectal fistulae, abscesses and diffuse inflammatory changes in the lower pelvis in 25 patients with Crohn's disease. Results were verified by surgery in eight patients and by correlation with findings on endoscopy, barium radiography and fistulography, and the clinical course in all other patients. EUS was superior to CT in diagnosing fistulae (14 vs 4 correct diagnoses) and inflammatory infiltration of the lower pelvic muscles (11 vs 2 correct diagnoses). The methods were equivalent in diagnosing perianorectal abscesses. CT was superior in the detection of inflammatory changes in the pararectal fasciae and fatty tissue which could not be detected by EUS. It is concluded that EUS should be used as the primary method for diagnosing perianorectal changes in patients with Crohn's disease especially in the case of fistulae and abscesses, having the added advantage of lack of radiation for the patient.

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