Noninvasive approach useful for detecting postoperative recurrence in Crohn’s disease

A noninvasive diagnostic approach that combines bowel ultrasound and faecal calprotectin test appears to be reliable for detecting disease recurrence in Crohn’s disease (CD) patients who have undergone ileo-cecal resection, according to a study.

The prospective study included 91 patients with CD treated with ileo-cecal resection in three referral Italian centres. All patients underwent colonoscopy and bowel ultrasound within 1 year after surgery. Researchers performed univariable and multivariable analyses to assess the correlation between noninvasive parameters and endoscopic recurrence defined by a Rutgeerts score (RS) of >2.

In total, 60 patients (66 percent) had endoscopic postoperative recurrence. Multivariable analysis revealed that bowel wall thickness was associated with endoscopic recurrence, such that each 1-mm increase in bowel wall thickness increased the risk of recurrence by more than two times (odds ratio [OR], 2.43, 95 percent confidence interval [CI], 1.21–4.89; p=0.012).

Other independent predictors of endoscopic recurrence were the presence of mesenteric lymph nodes (OR, 15.63, 95 percent CI, 1.48–164.54; p=0.022) and faecal calprotectin values ≥50 mcg/g (OR, 8.58, 95 percent CI, 2.45–29.99; p<0.001).

Furthermore, the presence of lymph nodes or the combination of bowel wall thickness ≥3 mm and faecal calprotectin values ≥50 mcg/g correctly identified 56 percent and 75 percent of patients with endoscopic recurrence, respectively; recurrence was falsely identified in <5 percent of patients.

Meanwhile, the combination of bowel wall thickness <3 mm and faecal calprotectin values <50 mcg/g correctly identified endoscopic recurrence in 74 percent of patients, with only 4.5 percent of these results being false.