Involvement of the small bowel by Crohn's disease can be classified using the changes seen on imaging studies. The pattern seen at a specific point is affected by disease activity and therapeutic interventions.
A single bowel segment may show more than one pattern, and adjacent bowel segments may show different patterns.
Ulcerations
Other Changes Seen
Subtype
superficial aphthae
minimal edema (minimal thickening or distortion of folds)
active inflammation, minimal
deep ulcerations, cobblestone mucosa
marked wall thickening from transmural inflammation; target sign; "comb sign", obstruction secondary to spasm
active inflammation, severe
NA
mild prestenotic dilatation; no mural edema; minimal bowel wall thickening; minimal decrease in luminal diameter
fibrostenotic, minimal stenosis
NA
prestenotic dilatation; marked bowel wall thickening with soft tissue density; marked decrease in luminal diameter
fibrostenotic, severe stenosis
deep fissuring ulcers, sinus tracts
fistulae to skin or other organs, presence of an inflammatory mass
fistulizing/perforating
NA
mucosal atrophy; regenerative polyps; no mural edema (minimal decrease in luminal diameter)
reparative or regenerative
To read more or access our algorithms and calculators, please log in or register.
