Value of color coded Doppler in the diagnosis of acute inflammatory and tumoral gastro-intestinal disease

Abstract

Objective: Although echotomography is a valuable method to diagnose certain acute bowel diseases, the non-specificity of the observed wall thickening is a limitation for a clear positive diagnosis in routine practice. Our hypothesis was that a wall thickening was accompanied by an increased blood flow in acute inflammatory and tumoral processes. Materials and methods: Color coded Doppler (CCD) has been used in emergency in 25 adults to objective possible changes in gastrointestinal blood flow. The final diagnosis was based on clinical records or results of surgery. Results: In the 10 control subjects, vessels were not detected in gallbladder or gastrointestinal walls. In the 25 patients (acute cholecystis, colon cancer, appendicitis, gastric lymphoma, Crohn's disease), CCD easily detected small arteries located at the periphery or within the thickened wall (one vessel in seven cases). In Crohn's disease, the presence of detected vessels would be an argument for establishing an increase in the inflammatory process. Conclusion: The presence of arterial blood flow in a thickened gastrointestinal wall is valuable for assessing a positive diagnosis of acute inflammatory or tumoral lesions.