Imaging Findings in Crohn's Disease
In contrast, Crohn's disease shows transmural inflammation and characteristically affects some areas of bowel and not others. Compared to ulcer-ative colitis, the colon is less affected in Crohn's disease but overall, Crohn's disease is more common than ulcerative colitis in children and therefore inflammatory bowel disease affecting the colon in children is most commonly Crohn's disease. Crohn's disease particularly affects the right side of the colon with sparing of the rectum and sigmoid colon. In the early stages barium enema will show nodular enlargement of lymphoid follicles and aphthous ulcers. As the disease progresses the findings are similar to those in adults, i.e. a cobblestone appearance to the bowel wall caused by longitudinal and transverse ulcers separated by areas of oedema, straightening and rigidity of the affected part of the colon, strictures and fistulae. Barium studies remain the mainstay of investigations, however, white cell studies (nuclear medicine) are useful for confirming acute exacerbation when anatomical detail is not required. Ultrasound is useful for showing a
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