Lemann et al reported a score for describing damage to the digestive tract. It can be monitored over time to follow the patient's disease progression. The authors are from multiple institutions from around the world.
Patient selection: Crohn's disease
Segments:
(1) upper digestive tract
(2) small bowel
(3) colon or rectu,
(4) anal or perianal
Parameters graded for each segment:
(1) stricturing lesion
(2) penetrating lesion
(3) history of surgery or other intervention
Parameter
Finding
Points
stricturing lesion
normal
0
wall thickening < 3 mm and/or segmental enhancement without prestenotic dilatation
1
wall thickening >= 3 mm and/or mural stratification without prestenotic dilatation
2
stricture with prestenotic dilatation
3
penetrating lesions
normal
0
deep transmural ulcer
2
abscess or any type of fistula
3
history of surgery or intervention
none
0
bypass diversion or stricturoplasty
2
resection
3
subscore for each segment =
= SUM(points for all 3 parameters)
score for entire GI tract =
= SUM(points for all 4 segments)
Interpretation:
• minimum subscore and total score: 0
• maximum subscore: 9
• maximum total score: 36
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