Bowel Ultrasonography in Crohn's Disease in Children: Wall Thickness Thresholds

Gastrointestinal ultrasonography (GIUS) is used in the diagnosis and monitoring of inflammatory bowel diseases, including Crohn's disease. Clinical recommendations from EFSUMB on intestinal ultrasound in IBD (Maconi et al., 2018) support the use of this method, including the application of graded compression and power Doppler for assessing disease activity in pediatric Crohn's disease before and after treatment (Thomson M et al., J Pediatr Gastroenterol Nutr 2012).

Ultrasound Features of Crohn's Disease

According to source fragments (Maconi et al., EFSUMB Consensus 2021), sonographic signs of inflammatory bowel involvement include:

— bowel wall thickening;
— pericolic fat reaction (hyperechoic appearance);
— detection of jejunal wall thickening as a sign suspicious for Crohn's disease.

Wall Thickness Thresholds in Children

In the provided source fragments, specific numerical thresholds for bowel wall thickness in the pediatric population in Crohn's disease are not specified [to be clarified]. The values of normal wall thickness cited in the sources refer to another anatomical region (renal pelvis wall) and cannot be extrapolated to bowel assessment.

Additional Techniques

Contrast-enhanced ultrasound (CEUS) and power Doppler are used to differentiate wall vascularization and assess inflammatory activity. In the literature cited in the fragments, CEUS is compared with endoscopy in children with Crohn's disease (Ponorac S et al., J Ultrasound Med 2023) and with CT enterography (Ding SS et al., Radiol Med 2022), and is also used for evaluating inflammatory and fibrotic stenoses (Schirin-Sokhan R et al., Digestion 2011).