Intestinal Ultrasound for Inflammatory Bowel Disease

Patients with inflammatory bowel disease (IBD) frequently utilize emergency department (ED) care. Intestinal ultrasound (IUS) is a noninvasive, point-of-care, radiation-free imaging modality increasingly used in outpatient IBD management. The purpose of this article is to introduce the use of IUS for the evaluation of IBD to emergency medicine physicians who utilize ultrasound as part of their clinical practice. Studies demonstrate that IUS is highly sensitive and specific for detecting active bowel inflammation. Key sonographic findings include increased bowel wall thickness and bowel wall hyperemia. IUS can also identify important IBD-related complications such as strictures and abscesses. IUS represents a promising addition to ED assessment of IBD and may serve as a valuable complementary tool for the initial evaluation of suspected IBD flare or disease-related complications. Its rapid bedside application, lack of required bowel preparation, and absence of radiation exposure make it particularly attractive in emergency and pediatric settings. Emerging evidence supports the feasibility of IUS using cart-based ultrasound systems and handheld ultrasound devices. With appropriate training, this may allow broad implementation in the ED. Further studies are needed to define optimal implementation strategies and evaluate its impact on clinical efficiency, reduction in radiation exposure, cost-effectiveness, and patient outcomes.