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Clinical Research/Articles |
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Colonic wall thickness measured by ultrasound: striking differences in patients
with cystic fibrosis versus healthy controls. |
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H P Haber, N Benda, G Fitzke, A Lang, M Langenberg, J Riethmüller and M Stern |
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Department of Pediatrics,
University of Tübingen, Germany.
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BACKGROUND: Colonic strictures
represent an advanced stage of fibrosing colonopathy in patients with
cystic fibrosis.
AIMS: To clarify
whether ultrasonography can identify patients with an early stage of
fibrosing colonopathy and to determine clinical factors that influence
bowel wall thickening.
PATIENTS: Ninety
patients with cystic fibrosis, median age 10 years, and 46 healthy controls,
median age 13 years, were investigated.
METHODS: Bowel
wall thickness was measured by ultrasound in a prospective study.
RESULTS: In cystic fibrosis,
wall thickness of both small intestine and colon was significantly (p
< 0.0001) higher than in controls; 81% of patients with cystic fibrosis
had a maximum colon wall thickness at any site of 2 mm or more, a value
that was never reached by controls. The maximum colon wall thickness
was 6.5 mm. Bowel wall thickness was unchanged at re-examination after
one year. There was no progression even with high dose pancreatic
supplements. There was no association between bowel wall thickness and
clinical features such as previous meconium ileus, intestinal resection,
distal intestinal obstruction syndrome, abdominal pain, or pancreatic
enzyme dose.
CONCLUSIONS: There is genuine
intestinal involvement in cystic fibrosis; in a few cases this
could lead to fibrosing colonopathy. |
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