Crohn's disease: CT enterography and CT enteroclysis

Abstract

Over the past decade or so, CT enterography and CT enteroclysis have rapidly gained acceptance as methods of assessing the small bowel, particularly in patients with Crohn's disease or obstructive symptoms. The first-line procedures for the diagnosis of Crohn's disease are ileocolonoscopy and biopsy of the terminal ileum. The aims of further investigation are to aid in establishing a firm diagnosis of Crohn's disease, and to evaluate disease extent, activity, severity, and the presence of penetrating disease, in order to direct appropriate medical or surgical treatment (Van Assche et al. 2010). Although capsule endoscopy is very sensitive for the detection of small bowel mucosal disease, it does not depict extraluminal disease. The utility of barium studies in assessment of Crohn's disease is limited by obscuration of overlapping small bowel loops and incomplete visualization of the extra-enteric complications of Crohn's disease.