Z Gastroenterol 2022; 60(06): 978-990
DOI: 10.1055/a-1801-0170
Leitlinie

Positionspapier zur Befunderhebung von Darmultraschallbefunden bei chronisch entzündlichen Darmerkrankungen

Position paper on reporting of intestinal ultrasound findings in patients with inflammatory bowel disease
Torsten Kucharzik
1   Klinik für Allgemeine Innere Medizin und Gastroenterologie, Klinikum Lüneburg, Lüneburg, Germany
,
Raja Atreya
2   Medizinische Klinik 1, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany (Ringgold ID: RIN27168)
,
Oliver Bachmann
3   Klinik für Innere Medizin 1, Siloah St. Trudpert Klinikum, Pforzheim, Germany
,
4   Division of Gastroenterology, University of Alberta, Edmonton, Canada (Ringgold ID: RIN3158)
,
Jan Daebritz
5   Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsmedizin Greifswald, Greifswald, Germany (Ringgold ID: RIN210462)
,
Ulf Helwig
6   Internistische Praxengemeinschaft Oldenburg, Oldenburg, Germany (Ringgold ID: RIN60635)
7   1. Med. Klinik, Universität Kiel, UKSH Kiel, Kiel, Germany
,
Johannes Janschek
8   Praxis für Gastroenterologie, Dresden, Germany
,
Peter Kienle
9   Allgemein-und Viszeralchirurgie, Theresienkrankenhaus und St. Hedwig-Klinik GmbH, Mannheim, Germany (Ringgold ID: RIN39850)
,
Jost Langhorst
10   Klinik für Integrative Medizin und Naturheilkunde, Sozialstiftung Bamberg, Klinikum am Bruderwald, Bamberg, Germany
,
Jonas Mudter
11   Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
,
Carsten Schmidt
12   Medizinische Klinik II, Universitätsmedizin Marburg-Campus Fulda, Klinikum Fulda AG, Fulda, Germany (Ringgold ID: RIN9227)
,
Andreas G. Schreyer
13   Institut für diagnostische und interventionelle Radiologie, Medizinische Hochschule Brandenburg, Universitätsklinikum Brandenburg a.d. Havel, Brandenburg an der Havel, Germany
,
Michael Vieth
14   Institut für Pathologie, Klinikum Bayreuth, Friedrich-Alexander Universität Erlangen-Nürnberg, Bayreuth, Germany
,
Johannes Wessling
15   Zentrum für Radiologie, Neuroradiologie und Nuklearmedizin, Clemenshospital Münster, Münster, Germany
,
Christian Maaser
16   Ambulanzzentrum Gastroenterologie, Klinik für Geriatrie, Klinikum Lüneburg, Lüneburg, Germany
› Author Affiliations

Zusammenfassung

Hintergrund Zur Diagnosestellung, Erkennung von Erkrankungskomplikationen sowie zur Verlaufskontrolle bei Patienten mit Morbus Crohn und Colitis ulcerosa wird zunehmend der Darmultraschall eingesetzt. Eine systematische Befunderhebung und Dokumentation sind wichtig, um die Qualität der Befunderstellung und die Kommunikation zwischen den Fachgruppen zu verbessern. Das vorliegende Positionspapier beschreibt die Voraussetzungen für eine optimale Befunderhebung des Darmultraschalls bei Patienten mit chronisch-entzündlichen Darmerkrankungen (CED).

Methoden Eine Experten-Konsensusgruppe bestehend aus Gastroenterologen, Radiologen, Pathologen, Kinder- und Jugend-Gastroenterologen und Chirurgen führte eine systematische Literaturrecherche durch. In einem Delphi-Verfahren wurde unter Mitgliedern des Kompetenznetzes Darmerkrankungen und der Deutschen Röntgengesellschaft (DRG) über relevante Kriterien bei der Befunderhebung von Darmultraschallbefunden abgestimmt. Die daraus resultierenden Statements wurden in einer Experten-Konsensusgruppe verabschiedet.

Ergebnis Praxisorientierte Empfehlungen für eine optimale Befunderhebung mit einer standardisierten Terminologie wurden entwickelt. Der Fokus der Erhebung lag auf der Beschreibung der Entzündungsaktivität sowie der Komplikationen bei CED. Minimale Anforderungen für eine standardisierte Befunderhebung wurden definiert.

Zusammenfassung Das vorliegende Manuskript bietet praktische Empfehlungen zur Optimierung und Vereinheitlichung der Befunderhebung bei Darmultraschall-Untersuchungen bei CED.

Abstract

Background Intestinal ultrasound is increasingly used for primary diagnosis, detection of complications and monitoring of patients with Crohn’s disease and ulcerative colitis. Standardization of reporting is relevant to ensure quality of the methodology and to improve communication between different specialties. The current manuscript describes the features required for optimized reporting of intestinal ultrasound findings in inflammatory bowel disease (IBD).

Methods An expert consensus panel of gastroenterologists, radiologists, pathologists, paediatric gastroenterologists and surgeons conducted a systematic literature search. In a Delphi- process members of the Kompetenznetz Darmerkrankungen in collaboration with members of the German Society for Radiology (DRG) voted on relevant criteria for reporting of findings in intestinal ultrasound. Based on the voting results statements were agreed by expert consensus.

Results Clinically relevant aspects of intestinal ultrasound (IUS) findings have been defined to optimize reporting and to standardize terminology. Minimal requirements for standardized reporting are suggested. The statements focus on description of disease activity as well as on complications of IBD. Attributes of intestinal inflammation are described and illustrated by exemplary images.

Conclusion The current manuscript provides practical recommendations on how to standardize documentation and reporting from intestinal ultrasound findings in patients with IBD.



Publication History

Received: 23 January 2022

Accepted: 15 March 2022

Article published online:
07 June 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • Literatur

  • 1 Panes J, Bouzas R, Chaparro M. et al. Systematic review: the use of ultrasonography, computed tomography and magnetic resonance imaging for the diagnosis, assessment of activity and abdominal complications of Crohn's disease. Aliment Pharmacol Ther 2011; 34: 125-145
  • 2 Buisson A, Gonzalez F, Poullenot F. et al. Comparative Acceptability and Perceived Clinical Utility of Monitoring Tools: A Nationwide Survey of Patients with Inflammatory Bowel Disease. Inflamm Bowel Dis 2017; 23: 1425-1433
  • 3 Horsthuis K, Bipat S, Bennink RJ. et al. Inflammatory Bowel Disease Diagnosed with US, MR, Scintigraphy, and CT: Meta-analysis of Prospective Studies. Radiology 2008; 247: 64-79
  • 4 Wilkens R, Novak KL, Maaser C. et al. Relevance of monitoring transmural disease activity in patients with Crohn's disease: current status and future perspectives. Therapeutic advances in gastroenterology 2021; 14
  • 5 Maaser C, Sturm A, Vavricka SR. et al. ECCO-ESGAR Guideline for Diagnostic Assessment in IBD Part 1: Initial diagnosis, monitoring of known IBD, detection of complications. J Crohns Colitis 2019; 13: 144-164
  • 6 Kucharzik T, Dignass AU, Atreya R. et al. Aktualisierte S3-Leitlinie „Diagnostik und Therapie der Colitis ulcerosa – Living Guideline“ der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechsel-krankheiten (DGVS). Z Gastroenterol 2020; 58: e241-e326
  • 7 Sturm A, Atreya R, Bettenworth D. et al. Aktualisierte S3-Leitlinie „Diagnostik und Therapie des Morbus Crohn“ der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechsel-krankheiten (DGVS). Z Gastroenterol 2022;
  • 8 Turner D, Ricciuto A, Lewis A. et al. STRIDE-II: An Update on the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) Initiative of the International Organization for the Study of IBD (IOIBD): Determining Therapeutic Goals for Treat-to-Target strategies in IBD. Gastroenterology 2021; 160: 1570-1583
  • 9 Kucharzik T, Tielbeek J, Carter D. et al. ECCO-ESGAR Topical Review on Optimizing Reporting for Cross-Sectional Imaging in IBD. J Crohns Colitis 2021;
  • 10 Novak KL, Nylund K, Maaser C. et al. Expert Consensus on Optimal Acquisition and Development of the International Bowel Ultrasound Segmental Activity Score [IBUS-SAS]: A Reliability and Inter-rater Variability Study on Intestinal Ultrasonography in Crohn's Disease. Journal of Crohn's & colitis 2021; 15: 609-616
  • 11 Sævik F, Eriksen R, Eide GE. et al. Development and Validation of a Simple Ultrasound Activity Score for Crohn's Disease. Journal of Crohn's & colitis 2021; 15: 115-124
  • 12 Allocca M, Fiorino G, Bonovas S. et al. Accuracy of Humanitas Ultrasound Criteria in Assessing Disease Activity and Severity in Ulcerative Colitis: A Prospective Study. J Crohns Colitis 2018; 12: 1385-1391
  • 13 Allocca M, Filippi E, Costantino A. et al. Milan ultrasound criteria are accurate in assessing disease activity in ulcerative colitis: external validation. United European Gastroenterol J 2021; 9: 438-442
  • 14 Goodsall TM, Jairath V, Feagan BG. et al. Standardisation of intestinal ultrasound scoring in clinical trials for luminal Crohn's disease. Aliment Pharmacol Ther 2021; 53: 873-886
  • 15 Messadeg L, Hordonneau C, Bouguen G. et al. Early Transmural Response Assessed Using Magnetic Resonance Imaging Could Predict Sustained Clinical Remission and Prevent Bowel Damage in Patients with Crohn’s Disease Treated with Anti-Tumour Necrosis Factor Therapy. Journal of Crohn's and Colitis 2020; 14: 1524-1534
  • 16 Bruining DH, Zimmermann EM, Loftus Jr EV. et al. Consensus Recommendations for Evaluation, Interpretation, and Utilization of Computed Tomography and Magnetic Resonance Enterography in Patients With Small Bowel Crohn's Disease. Gastroenterology 2018; 154: 1172-1194
  • 17 Goodsall TM, Nguyen TM, Parker CE. et al. Systematic Review: Gastrointestinal Ultrasound Scoring Indizes for Inflammatory Bowel Disease. J Crohns Colitis 2021; 15: 125-142
  • 18 Nylund K, Hausken T, Ødegaard S. et al. Gastrointestinal Wall Thickness Measured with Transabdominal Ultrasonography and Its Relationship to Demographic Factors in Healthy Subjects. Ultraschall in der Medizin – European Journal of Ultrasound 2012; 33: E225-E232
  • 19 Taylor SA, Mallett S, Bhatnagar G. et al. Diagnostic accuracy of magnetic resonance enterography and small bowel ultrasound for the extent and activity of newly diagnosed and relapsed Crohn's disease (METRIC): a multicentre trial. The Lancet Gastroenterology & Hepatology 2018; 3: 548-558
  • 20 Hallé E, Azahaf M, Duveau N. et al. Radiological Response Is Associated with Better Outcomes and Should Be Considered a Therapeutic Target in Crohn’s Disease. Digestive Diseases and Sciences 2019; 65: 2664-2674
  • 21 Kucharzik T, Wittig BM, Helwig U. et al. Use of Intestinal Ultrasound to Monitor Crohn’s Disease Activity. Clinical Gastroenterology and Hepatology 2017; 15: 535-542.e2
  • 22 Maaser C, Petersen F, Helwig U. et al. Intestinal ultrasound for monitoring therapeutic response in patients with ulcerative colitis: results from the TRUST&UC study. Gut 2020; 69: 1629-1636
  • 23 Maconi G, Nylund K, Ripolles T. et al. EFSUMB Recommendations and Clinical Guidelines for Intestinal Ultrasound (GIUS) in Inflammatory Bowel Diseases. Ultraschall in der Medizin – European Journal of Ultrasound 2018; 39: 304-317
  • 24 Bots S, Nylund K, Löwenberg M. et al. Ultrasound for Assessing Disease Activity in IBD Patients: A Systematic Review of Activity Scores. Journal of Crohn's and Colitis 2018; 12: 920-929
  • 25 Ripollés T, Martínez MJ, Paredes JM. et al. Crohn Disease: Correlation of Findings at Contrast-enhanced US with Severity at Endoscopy. Radiology 2009; 253: 241-248
  • 26 Esteban J, Maldonado L, Sanchiz V. et al. Activity of Crohn's disease assessed by colour Doppler ultrasound analysis of the affected loops. European Radiology 2001; 11: 1423-1428
  • 27 Ripollés T, Paredes JM, Martínez-Pérez MJ. et al. Ultrasonographic Changes at 12 Weeks of Anti-TNF Drugs Predict 1-year Sonographic Response and Clinical Outcome in Crohnʼs Disease. Inflammatory Bowel Diseases 2016; 22: 2465-2473
  • 28 Sasaki T, Kunisaki R, Kinoshita H. et al. Doppler ultrasound findings correlate with tissue vascularity and inflammation in surgical pathology specimens from patients with small intestinal Crohn's disease. BMC research notes 2014; 7: 363-363
  • 29 Lu C, Gui X, Chen W. et al. Ultrasound Shear Wave Elastography and Contrast Enhancement. Inflammatory Bowel Diseases 2017; 23: 421-430
  • 30 Novak KL, Kaplan GG, Panaccione R. et al. A Simple Ultrasound Score for the Accurate Detection of Inflammatory Activity in Crohnʼs Disease. Inflammatory Bowel Diseases 2017; 23: 2001-2010
  • 31 Saevik F, Eriksen R, Eide GE. et al. Development and Validation of a Simple Ultrasound Activity Score for Crohn's Disease. J Crohns Colitis 2021; 15: 115-124
  • 32 De Voogd F, Wilkens R, Gecse K. et al. A Reliability Study: Strong Inter-Observer Agreement of an Expert Panel for Intestinal Ultrasound in Ulcerative Colitis. Journal of Crohn's and Colitis 2021;
  • 33 Novak KL, Nylund K, Maaser C. et al. Expert Consensus on Optimal Acquisition and Development of the International Bowel Ultrasound Segmental Activity Score [IBUS-SAS]: A Reliability and Inter-rater Variability Study on Intestinal Ultrasonography in Crohn's Disease. J Crohns Colitis 2021; 15: 609-616
  • 34 Wilkens R, Hagemann-Madsen RH, Peters DA. et al. Validity of Contrast-enhanced Ultrasonography and Dynamic Contrast-enhanced MR Enterography in the Assessment of Transmural Activity and Fibrosis in Crohn′s Disease. Journal of Crohn's and Colitis 2017; 12: 48-56
  • 35 Bhatnagar G, Quinn L, Higginson A. et al. Observer agreement for small bowel ultrasound in Crohn's disease: results from the METRIC trial. Abdominal radiology (New York) 2020; 45: 3036-3045
  • 36 Kunihiro K, Hata J, Haruma K. et al. Sonographic detection of longitudinal ulcers in Crohn disease. Scandinavian Journal of Gastroenterology 2004; 39: 322-326
  • 37 Calabrese E, Kucharzik T, Maaser C. et al. Real-time Interobserver Agreement in Bowel Ultrasonography for Diagnostic Assessment in Patients With Crohn’s Disease: An International Multicenter Study. Inflammatory Bowel Diseases 2018; 24: 2001-2006
  • 38 Bots S, Nylund K, Löwenberg M. et al. Intestinal Ultrasound to Assess Disease Activity in Ulcerative Colitis: Development of a novel UC-Ultrasound Index. Journal of Crohn's and Colitis 2021;
  • 39 Ordás I, Rimola J, Alfaro I. et al. Development and Validation of a Simplified Magnetic Resonance Index of Activity for Crohn’s Disease. Gastroenterology 2019; 157: 432-439.e1
  • 40 Serafin Z, Bialecki M, Bialecka A. et al. Contrast-enhanced Ultrasound for Detection of Crohn's Disease Activity: Systematic Review and Meta-analysis. J Crohns Colitis 2016; 10: 354-362
  • 41 Serafin Z, Białecki M, Białecka A. et al. Contrast-enhanced Ultrasound for Detection of Crohn's Disease Activity: Systematic Review and Meta-analysis. Journal of Crohn's & colitis 2016; 10: 354-362
  • 42 Calabrese E, Zorzi F, Onali S. et al. Accuracy of small-intestine contrast ultrasonography, compared with computed tomography enteroclysis, in characterizing lesions in patients with Crohn's disease. Clin Gastroenterol Hepatol 2013; 11: 950-955
  • 43 Calabrese E, Petruzziello C, Onali S. et al. Severity of postoperative recurrence in Crohn's disease: correlation between endoscopic and sonographic findings. Inflamm Bowel Dis 2009; 15: 1635-1642
  • 44 Zorzi F, Ghosh S, Chiaramonte C. et al. Response Assessed by Ultrasonography as Target of Biological Treatment for Crohn's Disease. Clin Gastroenterol Hepatol 2020; 18: 2030-2037
  • 45 Fernandes SR, Rodrigues RV, Bernardo S. et al. Transmural Healing Is Associated with Improved Long-term Outcomes of Patients with Crohn's Disease. Inflamm Bowel Dis 2017; 23: 1403-1409
  • 46 Rutgeerts P, Geboes K, Vantrappen G. et al. Predictability of the postoperative course of Crohn's disease. Gastroenterology 1990; 99: 956-963
  • 47 Calabrese E, Petruzziello C, Onali S. et al. Severity of postoperative recurrence in crohnʼs disease: Correlation between endoscopic and sonographic findings. Inflammatory Bowel Diseases 2009; 15: 1635-1642
  • 48 Castiglione F, Bucci L, Pesce G. et al. Oral contrast-enhanced sonography for the diagnosis and grading of postsurgical recurrence of Crohnʼs disease. Inflammatory Bowel Diseases 2008; 14: 1240-1245
  • 49 Martínez MJ, Ripollés T, Paredes JM. et al. Intravenous Contrast-Enhanced Ultrasound for Assessing and Grading Postoperative Recurrence of Crohn’s Disease. Digestive Diseases and Sciences 2019; 64: 1640-1650
  • 50 Onali S, Calabrese E, Petruzziello C. et al. Endoscopic vs ultrasonographic findings related to Crohn's Disease recurrence: A prospective longitudinal study at 3years. Journal of Crohn's and Colitis 2010; 4: 319-328
  • 51 Paredes JM, Ripollés T, Cortés X. et al. Contrast-enhanced ultrasonography: Usefulness in the assessment of postoperative recurrence of Crohn's disease. Journal of Crohn's and Colitis 2013; 7: 192-201
  • 52 Louis E, Collard A, Oger AF. et al. Behaviour of Crohn's disease according to the Vienna classification: changing pattern over the course of the disease. Gut 2001; 49: 777-782
  • 53 Panes J, Bouhnik Y, Reinisch W. et al. Imaging techniques for assessment of inflammatory bowel disease: joint ECCO and ESGAR evidence-based consensus guidelines. J Crohns Colitis 2013; 7: 556-585
  • 54 Rieder F, Bettenworth D, Ma C. et al. An expert consensus to standardise definitions, diagnosis and treatment targets for anti-fibrotic stricture therapies in Crohn's disease. Aliment Pharmacol Ther 2018; 48: 347-357
  • 55 Guglielmo FF, Anupindi SA, Fletcher JG. et al. Small Bowel Crohn Disease at CT and MR Enterography: Imaging Atlas and Glossary of Terms. Radiographics 2020; 40: 354-375
  • 56 Bossuyt P, Debeuckelaere C, Ferrante M. et al. Risk Stratification for Surgery in Stricturing Ileal Crohn's Disease: The BACARDI Risk Model. J Crohns Colitis 2018; 12: 32-38
  • 57 Bouhnik Y, Carbonnel F, Laharie D. et al. Efficacy of adalimumab in patients with Crohn's disease and symptomatic small bowel stricture: a multicentre, prospective, observational cohort (CREOLE) study. Gut 2018; 67: 53-60
  • 58 Chaudhry NA, Riverso M, Grajo JR. et al. A Fixed Stricture on Routine Cross-sectional Imaging Predicts Disease-Related Complications and Adverse Outcomes in Patients with Crohn's Disease. Inflamm Bowel Dis 2017; 23: 641-649
  • 59 Schulberg JD, Wright EK, Holt BA. et al. Magnetic resonance enterography for predicting the clinical course of Crohn's disease strictures. J Gastroenterol Hepatol 2020; 35: 980-987
  • 60 Stocker D, King MJ, El Homsi M. et al. Luminal narrowing alone allows an accurate diagnosis of Crohn's disease small bowel strictures at cross-sectional imaging. J Crohns Colitis 2020;
  • 61 Rimola J, Capozzi N. Differentiation of fibrotic and inflammatory component of Crohn's disease-associated strictures. Intest Res 2020; 18: 144-150
  • 62 Rieder F, Zimmermann EM, Remzi FH. et al. Crohn's disease complicated by strictures: a systematic review. Gut 2013; 62: 1072-1084
  • 63 Li C, Kuemmerle JF. Mechanisms that mediate the development of fibrosis in patients with Crohn's disease. Inflamm Bowel Dis 2014; 20: 1250-1258
  • 64 Orscheln ES, Dillman JR, Towbin AJ. et al. Penetrating Crohn disease: does it occur in the absence of stricturing disease?. Abdom Radiol (NY) 2018; 43: 1583-1589
  • 65 Baumgart DC, Muller HP, Grittner U. et al. US-based Real-time Elastography for the Detection of Fibrotic Gut Tissue in Patients with Stricturing Crohn Disease. Radiology 2015; 275: 889-899
  • 66 Allocca M, Fiorino G, Bonifacio C. et al. Noninvasive Multimodal Methods to Differentiate Inflamed vs Fibrotic Strictures in Patients With Crohn's Disease. Clin Gastroenterol Hepatol 2019; 17: 2397-2415
  • 67 Weber NK, Fletcher JG, Fidler JL. et al. Clinical characteristics and imaging features of small bowel adenocarcinomas in Crohn's disease. Abdom Imaging 2015; 40: 1060-1067
  • 68 Radmard AR, Amouei M, Kooraki S. et al. Potenzial MR Enterography Features to Differentiate Primary Small Intestinal Lymphoma from Crohn Disease. American Journal of Roentgenology 2020; 215: 864-873
  • 69 Magro F, Langner C, Driessen A. et al. European consensus on the histopathology of inflammatory bowel disease. J Crohns Colitis 2013; 7: 827-851
  • 70 Rees MA, Dillman JR, Anton CG. et al. Inter-radiologist agreement using Society of Abdominal Radiology-American Gastroenterological Association (SAR-AGA) consensus nomenclature for reporting CT and MR enterography in children and young adults with small bowel Crohn disease. Abdom Radiol (NY) 2019; 44: 391-397
  • 71 Herrmann KA, Michaely HJ, Zech CJ. et al. Internal fistulas in Crohn disease: magnetic resonance enteroclysis. Abdom Imaging 2006; 31: 675-687
  • 72 Braithwaite KA, Alazraki AL. Use of the star sign to diagnose internal fistulas in pediatric patients with penetrating Crohn disease by MR enterography. Pediatr Radiol 2014; 44: 926-931
  • 73 Sampietro GM, Casiraghi S, Foschi D. Perforating Crohn's disease: conservative and surgical treatment. Dig Dis 2013; 31: 218-221
  • 74 Bollegala N, Griller N, Bannerman H. et al. Ultrasound vs Endoscopy, Surgery, or Pathology for the Diagnosis of Small Bowel Crohn's Disease and its Complications. Inflamm Bowel Dis 2019; 25: 1313-1338
  • 75 Baker ME, Fletcher JG, Al-Hawary M. et al. Interdisciplinary Updates in Crohn's Disease Reporting Nomenclature, and Cross-Sectional Disease Monitoring. Radiol Clin North Am 2018; 56: 691-707
  • 76 Goldstone RN, Steinhagen RM. Abdominal Emergencies in Inflammatory Bowel Disease. Surg Clin North Am 2019; 99: 1141-1150
  • 77 Shin D, Rahimi H, Haroon S. et al. Imaging of Gastrointestinal Tract Perforation. Radiol Clin North Am 2020; 58: 19-44
  • 78 Ripollés T, Martínez-Pérez MJ, Paredes JM. et al. Contrast-enhanced ultrasound in the differentiation between phlegmon and abscess in Crohn's disease and other abdominal conditions. Eur J Radiol 2013; 82: e525-e531
  • 79 Duszak Jr RL, Levy JM, Akins EW. et al. Percutaneous catheter drainage of infected intra-abdominal fluid collections. American College of Radiology. ACR Appropriateness Criteria. Radiology 2000; 215: 1067-1075
  • 80 Richards RJ. Management of abdominal and pelvic abscess in Crohn's disease. World J Gastrointest Endosc 2011; 3: 209-212
  • 81 Feagins LA, Holubar SD, Kane SV. et al. Current strategies in the management of intra-abdominal abscesses in Crohn's disease. Clin Gastroenterol Hepatol 2011; 9: 842-850
  • 82 Gervais DA, Brown SD, Connolly SA. et al. Percutaneous imaging-guided abdominal and pelvic abscess drainage in children. Radiographics 2004; 24: 737-754
  • 83 Okita Y, Mohri Y, Kobayashi M. et al. Factors influencing the outcome of image-guided percutaneous drainage of intra-abdominal abscess after gastrointestinal surgery. Surg Today 2013; 43: 1095-1102
  • 84 Patel IJ, Davidson JC, Nikolic B. et al. Consensus guidelines for periprocedural management of coagulation status and hemostasis risk in percutaneous image-guided interventions. J Vasc Interv Radiol 2012; 23: 727-736
  • 85 Violi NV, Schoepfer AM, Fournier N. et al. Prevalence and clinical importance of mesenteric venous thrombosis in the Swiss Inflammatory Bowel Disease Cohort. AJR Am J Roentgenol 2014; 203: 62-69
  • 86 Smith RL, Taylor KM, Friedman AB. et al. Systematic Review: Clinical Utility of Gastrointestinal Ultrasound in the Diagnosis, Assessment and Management of Patients With Ulcerative Colitis. J Crohns Colitis 2020; 14: 465-479
  • 87 Desai J, Elnaggar M, Hanfy AA. et al. Toxic Megacolon: Background, Pathophysiology, Management Challenges and Solutions. Clin Exp Gastroenterol 2020; 13: 203-210