Intestinal Ultrasound in the Diagnosis of Crohn’s Disease of the Ileoanal Pouch: A Clinical Case
D. D. Mukhametova,
L. R. Ismailova,
O. E. Tabakchi,
A. F. Shakurov,
L. R. Sadykova,
R. A. Khramov,
E. S. Petrov,
A. Kh. Odintsova,
D. I. Abdulganieva https://doi.org/10.22416/1382-4376-2026-36-2-113-116
Abstract
Aim: to demonstrate the utility of ultrasound in evaluating of Crohn’s disease with multiple extraintestinal manifestations after restorative proctocolectomy.
Key points: Patient S., a 40-year-old female, was admitted to the clinic presenting with frequent bloody stools, abdominal pain in left lower quadrant and fever. She had a history of ulcerative colitis diagnosed in 2005. In 2021, the disease was complicated by toxic megacolon requiring a colectomy and an end ileostomy. In 2022, the second stage of surgical treatment was performed: proctectomy with ileal pouch-anal anastomosis. In 2023, the patient developed extraintestinal manifestations: aphthous stomatitis, erythema nodosum, and left ankle arthritis. Examination revealed ultrasound signs of Crohn’s disease: significant thickening of the bowel wall (predominantly of the muscularis propria and submucosa) with loss of wall stratification, as well as pathological vascularization of the ileoanal anastomosis, indicating transmural inflammation. Ileoscopy revealed linear ulcers, and histology showed inflammatory infiltration extending to the muscular layer, confirming the diagnosis of Crohn’s disease. Therapy with ustekinumab was initiated with positive clinical response and disease remission.
Conclusion. Ultrasound has revealed signs of transmural inflammation of the ileal pouch and allowed to suspect Crohn’s disease, which has been subsequently confirmed by endoscopic and histological examinations.
Keywords
Supporting agencies: the work was carried out with financial support from the grant of the Academy of Sciences of the Republic of Tatarstan, provided to young candidates of science (postdoctoral students) for the purpose of defending a doctoral dissertation, carrying out research work, and also performing work functions in scientific and educational organizations of the Republic of Tatarstan “Scientific and Technical Development of the Republic of Tatarstan”
About the Authors
D. D. Mukhametova
Kazan State Medical University
Russian Federation
Russian Federation
Dilyara D. Mukhametova — Cand. Sci. (Med.), Associate Professor of the Department of Hospital Therapy
420012, Kazan, Butlerova str., 49.
L. R. Ismailova
Kazan State Medical University
Russian Federation
Russian Federation
Lilia R. Ismailova — Student of General Medicine Faculty
420012, Kazan, Butlerova str., 49.
O. E. Tabakchi
Kazan State Medical University
Russian Federation
Russian Federation
Olga E. Tabakchi — Postgraduate of the Department of Hospital Therapy
420012, Kazan, Butlerova str., 49.
A. F. Shakurov
Kazan State Medical University; Republican Clinical Hospital
Russian Federation
Russian Federation
Aydar F. Shakurov — Cand. Sci. (Med.), Associate Professor of the of the Department of Surgical Diseases; Coloproctologist, Coloproctology Department
420012, Kazan, Butlerova str., 49.
L. R. Sadykova
Republican Clinical Hospital
Russian Federation
Russian Federation
Leila R. Sadykova — Gastroenterologist, Gastroenterology Department
420064, Kazan, Orenburgsky tract, 138.
R. A. Khramov
Republican Clinical Hospital
Russian Federation
Russian Federation
Roman A. Khramov — Endoscopist, Endoscopy Department
420064, Kazan, Orenburgsky tract, 138.
E. S. Petrov
Republican Clinical Hospital
Russian Federation
Russian Federation
Evgeniy S. Petrov — Pathologist, Pathological Anatomy Department
420064, Kazan, Orenburgsky tract, 138.
A. Kh. Odintsova
Republican Clinical Hospital
Russian Federation
Russian Federation
Alfiya Kh. Odintsova — Cand. Sci. (Med.), Head of the Gastroenterology Department
420064, Kazan, Orenburgsky tract, 138.
D. I. Abdulganieva
Kazan State Medical University; Republican Clinical Hospital
Russian Federation
Russian Federation
Diana I. Abdulganieva — Dr. Sci. (Med.), Professor, Head of the Gastroenterology Department
420012, Kazan, Butlerova str., 49.
References
1. Bohra A., Van Langenberg D.R., Vasudevan A. Intestinal ultrasound in the assessment of luminal Crohn’s disease. Gastrointest Disord. 2022;4(4):249–62. DOI: 10.3390/gidisord4040024
2. Spinelli A., Bonovas S., Burisch J., Kucharzik T., Adamina M., Annese V., et al. ECCO guidelines on therapeutics in ulcerative colitis: Surgical treatment. J Crohn’s Colitis. 2022;16(2):179–89. DOI: 10.1093/ecco-jcc/jjab177
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For citations:
Mukhametova D.D., Ismailova L.R., Tabakchi O.E., Shakurov A.F., Sadykova L.R., Khramov R.A., Petrov E.S., Odintsova A.Kh., Abdulganieva D.I. Intestinal Ultrasound in the Diagnosis of Crohn’s Disease of the Ileoanal Pouch: A Clinical Case. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2026;36(2):113-116. https://doi.org/10.22416/1382-4376-2026-36-2-113-116
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