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Crohn's Disease Forum » Tests for IBD » Anyone have ultra sound done?


10-31-2014, 12:50 PM   #1
nogutsnoglory
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Anyone have ultra sound done?

I heard that ultra sound was being used more for IBD particularly in pediatric patients who will not do well in an MRI or CT scan machine.

Anyone have this done? Would it pick up abscess or fistula formation?
10-31-2014, 12:55 PM   #2
valleysangel92
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I've had 5 ultrasounds over the years, first at 15, last was just before diagnosis at 19, they never really picked anything up for me, except the last one which showed an elevated amount of free fluid in my abdomen which they told me was caused by inflammation.

I've not had one since they diagnosed me and they've not mentioned one to me either. I think they can pick up abscesses and maybe would be able to see a fistula but in my experience aren't great for picking up inflammation inside the bowel unless it's caused the bowel to become enlarged.
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10-31-2014, 01:04 PM   #3
nogutsnoglory
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Yeah I wouldn't trust it for the real story inside but I have had so many MRI's for abscesses and fistulas that I'd like an easier, faster and less invasive test if possible.
10-31-2014, 02:32 PM   #4
DustyKat
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Both of my kids have had ultrasounds and I too have recently have had one done for abdominal pain.

I personally don’t think an ultrasound will pick up an intra abdominal fistula but they can be good at detecting inflammation and enlargement of organs and the bowel, masses, abscesses and stones (gall and kidney).

From our own experience they are only as good as the person interpreting the results, but that could be said of any imaging, and I do feel when it comes to the bowel you have a better chance of a positive outcome if they have some idea of what they are looking for and where the problem lay.

Sarah: Undiagnosed and was sent for a renal ultrasound. It did show hydronephrosis but due to the limitations of the amount of area that can be seen at any one time it didn’t pick up the mess the adjacent ileum was in. But it was a renal ultrasound only. As such they also ran it over the pelvic area and it picked up quite a bit of fluid in the Pouch of Douglas. I asked the doctor about this and he said it was likely from a burst ovarian follicle. In hindsight it was pus.

Matt: When Crohn’s was suspected, and with Sarah’s history, ultrasound was directed straight to the terminal ileum. They found nothing untoward except some free fluid in the abdominal cavity of unknown significance. The GI didn’t believe it based on what the GP had told him so he was sent for a repeat the next day. This time the Radiologist was in the room with the sonographer and lo and behold they found thickening of the terminal ileum.
He has also had a renal and urinary tract ultrasound to ruled out abnormalities following complaints of pain in that area and that appeared to be spot on in finding no issues. And lastly he has had another one for an queried inguinal hernia and that did pick one up.

Me: Upper abdominal organs. Showed no abnormalities aside from a few gall stones and mildly fatty liver. Didn’t explain away my pain so that will leave further testing for another day.

So yeah, I do think they are a very useful tool but in my own mind do have a few limitations.

Dusty. xxx
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10-31-2014, 02:34 PM   #5
DustyKat
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I meant to add that the reason I don’t think they would pick up a fistula is, for a fistula to form you have to have inflammation and therefore swelling. In the context of an ultrasound I think the inflammation and swelling would mask the fistula.
10-31-2014, 04:25 PM   #6
SarahD
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I've had several ultrasounds. Like Dusty said, they are only as good as the person interpreting the results. I was hospitalised with suspected appendicitis, given an ultrasound which found nothing. A few weeks after being discharged I was still having pain so I was sent for a second ultrasound, which this time picked up on some thickening around my TI. I'm not sure if they are detailed enough to pick up on small things like a fistula could be, but I would think they would pick up something larger like an abscess. I do think you get a clearer picture with an MRI or CT scan though.
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Symptoms from the age of 12. Mis-diagnosed with UC at the age of 13, and later diagnosed with Crohn's in January 2012 at 24 years old. Disease mainly in terminal ileum.


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10-31-2014, 05:06 PM   #7
poppets mum
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My daughter at age 7 was given ultrasound for abdo pain, which showed free fluid. Then a ct which picked up her intra abdominal abscess. She had quite a few ultrasounds after, as it seemed once they knew where and what to look for it was quite useful.
10-31-2014, 07:39 PM   #8
nogutsnoglory
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Seems to be seldom used and for kids. I hope they begin using it more for adults.
10-31-2014, 08:07 PM   #9
DustyKat
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Ngng - It is true that is more likely to be used in children but I also think you might find that the differing health systems between the US and the other countries may also play a part in how extensively it is used. For those of us with universal healthcare if ultrasound is a reasonable option it will likely be used first as it uses no radiation and is one of the cheaper forms of imaging. So for us it is used widely in the adult population.
10-31-2014, 08:39 PM   #10
Muppetgirl
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I agree that its probably most useful in measuring things and where fluid is involved. In endometriosis it is good for endometriomas (capsules of endometriosis filled with old blood), but traditionally poor for other lesions which are solid. However, I believe it now has some sucess with recto-vaginal endo, (though it requires specialist skills on the part of the sonographer), such skills may be transferable to imaging other bowel problems. Like dusty says its a popular first approach because its much cheaper than other forms of imaging.

Dusty - I've come to distrust that phrase 'of unknown significance' in radiology. I get why they use it, but on the two occasions it was in my report, it also turned out to be very significant indeed!
10-31-2014, 08:59 PM   #11
DustyKat
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Dusty - I've come to distrust that phrase 'of unknown significance' in radiology. I get why they use it, but on the two occasions it was in my report, it also turned out to be very significant indeed!
I agree wholeheartedly! To me ‘unknown significance’ is just a far more succinct way of saying...‘we don’t have a bloody clue why the hell there is something where it shouldn’t be!’
11-07-2014, 03:25 PM   #12
DEmberton
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Ultra sound was the very first test I had when I was referred by my GP. I guess it was the quickest and easiest (and cheapest) thing to do. I think at that stage the main reason was to look for tumors, so it was a relief when it was clear. It took another 9 months before I found out it was Crohn's.
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11-07-2014, 08:34 PM   #13
Catherine
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We had the term unknown significance used with ultrasound as well. This was area where her small bowel was thickened.

If the dr had read the report correctly we would be referred to a GI six months earlier.
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11-09-2014, 06:00 PM   #14
Grumbletum
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Ultrasound was the first test I was referred for too but that was cos my GP thought I might have an ovarian cyst or such like ( had one operated on about 30 years ago. The radiographer told me that he couldn't see anything like that but that a section of my bowel wasn't pulsating like it should. That got me on track for my eventual CD diagnosis.
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