Role of Trans perineal Ultrasound in Inflammatory Bowel Disease

Abstract Background Inflammatory Bowel Disease (IBD) is a medical terminology for a group of diseases that cause chronic intestinal inflammation. It is categorized into two subtypes: Ulcerative colitis and Crohn’s disease. Fistulae are frequently seen manifestations of perianal IBD, and their clinical course these consists of flare-ups with bouts of active drainage, followed by intervals of clinical remission. Improved prognosis, treatment, and assessments of perianal disease activity may all contribute to a better patient quality of life. Aim of the Work to explore the role of trans perineal ultrasound in assessment of disease activity and/or complications in patients with inflammatory bowel disease. Patients and Methods The Diagnostic Radiology Unit; Radiology Department, Ain Shams University Hospitals. For 6 months. We studied the relevance of 23 different ultrasound parameters and 6 indices in conjunction with clinical, endoscopic based scores. Sample size of at least 30 patients with IBD with affection of anal or perianal area were sufficient to achieve study objective. Results Rectal wall thickness and submucosal band thickness could be used as indicators for presence of disease in ulcerative colitis patients. TPUS could be used to assess the internal sphincter thickness, external sphincter integrity in Crohn’s disease. Partial Mayo clinical score showed significant correlation with Mayo endoscopic score; however, it couldn’t predict degree of severity. Internal sphincter thickening increased anal canal vascularity and perianal fistula is more common in Crohn’s disease than ulcerative colitis. Conclusion Trans perineal ultrasound is considered as a good tool that is noninvasive, cost effective and convenient and shows a potential in the assessment of disease activity and complications in inflammatory bowel disease.