Endoscopy 2018; 50(04): S107
DOI: 10.1055/s-0038-1637347
ESGE Days 2018 ePoster Podium presentations
20.04.2018 – IBD, coeliac and other
Georg Thieme Verlag KG Stuttgart · New York

ENDOSONOGRAPHIC PREDICTION OF HISTOPATHOLOGICAL SEVERITY AND DYSPLASIA IN ULCERATIVE COLITIS

A Elrabat
1   Hepatology and Gastroenterology, Mansora University, Mansourah, Egypt
,
M Maher
1   Hepatology and Gastroenterology, Mansora University, Mansourah, Egypt
,
F Abozeid
1   Hepatology and Gastroenterology, Mansora University, Mansourah, Egypt
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

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Aims:

Ulcerative colitis (UC) is one of the most common forms of IBD. Endoscopic ultrasound is a highly accurate diagnostic endoscopic and radiological modality for the assessment of rectal pathology by measuring colon wall thickness and the surrounding structure. The aim of this study is to evaluate the role of EUS in determination of severity of UC and its correlation with clinical, endoscopic and histopathological parameters.

Methods:

52 ulcerative colitis patients were cross-sectionally evaluated by clinical (Truelovescore), laboratory (CBC, CRP, ESR, fecalcalprotectine) and endoscopy (Mayo score). They were divided into 3 groups: mild, moderate and severe ulcerative colitis. They were subjected to EUS at 10 cm, 20 cm and 30 cm from anal verge to assess the severity of UC in correlation to histopathological examination.

Results:

TWT at 10 cm was positively correlated with high significance (p = 0.001) to histopathological severity in comparison to 20 cm and 30 cm from anal verge.

On EUS, 30 (57.7%) patients had irregular muscle layer, and this was correlated to the longer duration of the disease (p = 0.04).

TWT at 10 cm by EUS was found to be a significant predictor of histopathological severity of UC (p = 0.007).

TWT of the colon at 10 cm from anal verge with a cut off 3.15 mm can discriminate significantly (p = 0.02) between severe UC cases and mild to moderate cases from the other side with sensitivity of 78% and specificity of 60%, while TWT of 5.05 mm at 10 cm from anus was highly significant (p = 0.006) to discriminate mucosal dysplasia in UC with sensitivity 75% and specificity of 94%.

Conclusions:

EUS at 10 cm from anal verge with TWT 3.15 mm can assess histopathological severity of UC, and with TWT 5.05 mm can predict dysplasia in UC and this result can determine which patient should be biopsied and site to be biopsied for fear of malignant transformation on the basis of EUS measurements.