P080 - Use of abdominal ultrasonography in detection of possible asymptomatic thrombosis in patients with inflammatory bowel disease including evaluation of inherited and acquired prothrombotic factors

Abstract

Introduction: Ano-rectal ultrasonography (AR-EUS) is a simple and well-tolerated method, with a high diagnostic acuity in the evaluation of perianal complications of inflammatory bowel disease (IBD). Aim: Characterization of ano-rectal ultrasonography findings in patients with IBD. Methods: We evaluated 98 patients with IBD, who had confirmed or suspected perianal involvement and were submmited to AR-EUS in the period between January 2000 and January 2008. Demographic, clinical and ultrasonographic data were collected. Results: One hundred and three AR-EUS were performed in this period, in a total of 98 patients with IBD. Seven patients had ulcerative colitis (UC) and 91 patients had Crohn’s disease (CD). Male gender: 49%, mean age: 41.84±12.28 years. A mean of 1.97±1.2 AR-EUS per patient were performed. Mean duration of IBD was 10.86±7.65 years and mean duration of perianal disease was 6.42±5.26 years. Crohn’s disease location was ileal (L1) in 25.3%, colonic (L2) in 30.7% and ileocolonic (L3) in 44% of the patients, and had inflammatory behaviour (B1p) in 47.6%, stricturing behaviour (B2p) in 28% and penetrating behaviour (B3p) in 24.4% of the patients. Seventeen four patients have been submmited to perianal surgery, and setons were placed in 48 patients. Medical treatment with antibiotherapy in 86.4%, azathioprine/6-MP in 65.4%, methotrexate in 10.2% and biologic therapy in 34.1% of the patients. Ultrasonography findings in UC patients were the following: perianal abscess: 2 patients; perianal fistula: 7 patients (intersphincteric 3, transphincteric 2, suprasphincteric 1, anovaginal 1); echostructural changes: 1 patient. Ultrasonography findings in CD patients were the following: perianal abscess: 35 patients; perianal fistula: 112 patients (superficial 2, intersphincteric 52, transphincteric 45, suprasphincteric 27, anovaginal 9, rectovaginal 1, ano-urethral 2); echostructural/cicatricial changes: 34 patients; internal anal sphincter laceration: 21 patients; external anal sphincter laceration: 4 patients; anal fissure: 10 patients; anal stenosis: 1 patient. Conclusion: Most ano-rectal ultrasonographic findings in patients with IBD represent suppurative complications, although we have also found a high prevalence of echostructural changes and sphincteric lacerations, most due to prolonged and recurrent suppurative processes and surgical complications. AREUS plays a major role in the evaluation of the IBD patient with perianal involvement. P080 Use of abdominal ultrasonography in detection of possible asymptomatic thrombosis in patients with inflammatory bowel disease including evaluation of inherited and acquired prothrombotic factors