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Figure 5.27. Recurrent Crohn's disease. (A) Transverse and (B) longitudinal sonograms of the right lower quadrant reveal an abnormal loop of small bowel characterized by an echogenic mucosal layer in the center of the bowel, and surrounding alternating layers of sonolucency and echogenicity. These are nonspecific changes of Crohn's or other inflammatory disease of the small bowel. (C) Small-bowel series on the same patient shows typical findings of Crohn's disease in the neoterminal ileum. (Courtesy of R. Wachsberg, M.D., Newark, NJ)

Figure 5.27. Recurrent Crohn's disease. (A) Transverse and (B) longitudinal sonograms of the right lower quadrant reveal an abnormal loop of small bowel characterized by an echogenic mucosal layer in the center of the bowel, and surrounding alternating layers of sonolucency and echogenicity. These are nonspecific changes of Crohn's or other inflammatory disease of the small bowel. (C) Small-bowel series on the same patient shows typical findings of Crohn's disease in the neoterminal ileum. (Courtesy of R. Wachsberg, M.D., Newark, NJ)

narrowing may still be reversible [101,102]. In time, the loops of bowel may become matted together. Based on these and other studies, ultrasound may play an important role in limiting radiation exposure for patients with a chronic disease that can reach from childhood to patients with advanced maturity [97-99].

The postoperative CT appearance of Crohn's disease [103] parallels that seen preoperatively [100]. Increased bowel wall thickness, inflammatory masses, so-called fibrofatty changes in the mesentery and regional adenopathy were most commonly encountered (Fig. 5.28).

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