Crohn’s disease clinical issues and treatment: what the radiologist needs to know and what the gastroenterologist wants to know

Abstract

Crohn's disease is an idiopathic chronic intestinal illness that requires specialized medical care for prompt disease diagnosis and appropriate management. Clinicians must accurately interpret and integrate findings from multitude of sources in order to achieve diagnostic certainty. Ileocolonoscopy remains the most relied modality, allowing for a direct mucosal visualization and biopsies for histologic assessments. Serologic markers currently serve an adjunctive role, often utilized in attempts to further subtype patients with indeterminate colitis. Radiologic imaging, such as computed tomography enterography can evaluate the far reaches of the small intestine, while also providing information about penetrating complications and extraintestinal disease manifestations. Treatment options and strategies continue to evolve with new biologic agents and ongoing testing of aggressive "top-down" approaches. In addition, identification of increased colorectal cancer risks in individuals with Crohn's colitis has led to formal surveillance guidelines. The clinical diagnosis and management of Crohn's disease continues to be an area of rapid change and exciting developments.