Intestinal ultrasound for monitoring postoperative Crohn’s disease: A systematic review and clinical implications

Figure 1  Preferred Reporting Items for Systematic reviews and Meta-Analyses flow diagram illustrating the study selection process for this scoping review.

Figure 2 Multimodal assessment of the ileo-colonic anastomosis in postoperative Crohn’s disease. A: Transabdominal ultrasound showing a thickened anastomotic site between the colon and ileum (marked with an asterisk) with gap in the submucosa; B: Measurement of bowel wall thickness (5.79 mm) proximal to the ileo-colonic anastomosis in neo-terminal ileum using high-frequency ultrasound; C: Ileocolonoscopic image showing ulcerated anastomotic site with suture material and few ulcers in neo-terminal ileum; D: Endoscopic view of the ulcerated anastomostic site with proximal ulcerations.

Figure 3 Suggested surveillance algorithm integrating intestinal ultrasound and fecal calprotectin for monitoring postoperative Crohn’s disease. BWT: Bowel wall thickness; FCP: Fecal calprotectin; NPV: Negative predictive value; IUS: Intestinal ultrasound; ICA: Ileocolonic anastomosis; CEUS: Contrast enhanced ultrasound; SICUS: Small intestine contrast ultrasound.