P172 Postoperative recurrence of Crohn's disease: correlation between endoscopy and bowel ultrasound

• Published in: Journal of Crohn's and colitis 2019-01, Vol.13 (Supplement_1), p.S175-S175
• Main Authors: Yebra Carmona, J, Suárez Ferrer, C, Poza Cordón, J, Rueda García, J L, Lucas Ramos, J, Andaluz García, I, Martín Arranz, E, Gómez Senent, S, Martín Arranz, M D, Mora Sanz, P
• Format: Article
• Language: English
• ISSN: 1873-9946; 1876-4479
• DOI: 10.1093/ecco-jcc/jjy222.296

Abstract Background Postoperative Crohn’s disease recurrence (POR) is currently assessed by ileocolonoscopy. B-mode bowel sonography (US) is an alternative, non-invasive, non-ionising and well tolerated diagnostic method. Our aim was to validate US, and to establish a correlation between the different ultrasound parameters of activity and Rutgeerts endoscopic score Methods We selected 31 patients with Crohn’s disease in follow-up at our unit, who had underwent surgical ileocolic resection, which performed ileocolonoscopy and US for the diagnosis of POR, with a difference between both tests lesser than 6 months. Recurrence was assessed by ileocolonoscopy using the Rutgeerts score, considering: i0–i1 absence of recurrence; ≥i2 endoscopic recurrence. The echographic findings were bowel wall thickness (BWT), hyperaemia, layer pattern, involvement of the mesenteric fat, presence of adenopathy and transmural complications (fistulas and abscesess). Results Clinical characteristics of the study population are reported in Table 1. Female 16 (51%) Age at diagnosis A1 2 (6,7%); A2 22 (73.3%); A3 6 (20%) Disease location L1 14 (45.2%); L2 0(0%); L3 17 (54.8%) Illness behaviour at diagnosis B1 3 (9.7%); B2 17(54.8%); B3 11 (35.5%) Smoke habit Smoker 9 (29%); ex-smoker 14 (45%); non-smoker 8 (26%) Number of surgical resection one: 27 (87%); two: 4 (13%) Treatment non 6(20%); azathioprine 5 (16%); anti-TNF 8 (26,7%); combined 11 (36%) Rutgeerts score io–i1: 11 (35.5%); i2: 10 (32%); i3–i4: 10 (32%) Endoscopic recurrence ≥i2: 20 (64,5%) Faecal calprotectin >50 ng/mg: 18 (58%) Main demographic, clinical characteristics according to Montreal classification. Ileoconoloscopy detected recurrence in 20 of 31 patients (64%). A statistically significant association was identified between wall thickness and recurrence (i ≥ 2) (mean 2.5 mm non recurrence vs. 5.2 mm recurrence, p = 0.002). A relationship was observed between Rutgeerts endoscopic score and BWT: 2.5 mm (SD 0.39) for i0–i1; 3.68 mm (SD 0.33) for i2 and 6.79 mm (SD 0.29) for i3–i4. However, this relationship did not reach statistical significance (p = 0.57). To establish the relationship between each of the ultrasound variables with the endoscopic recurrence, a multi-variate analysis was performed using logistic regression. It was identified that a BWT< 3 mm is associated with the possibility of endoscopic recurrence with a relative risk reduction (RRR) of 2.03, the preservation of the layer pattern RRR = 1.05, the abse