白浜 正文¹, 田中 智子^{1, 2}, 久木田 穣次^{1, 2}, 下田 悠一郎 ^{1, 2, 3}, 石橋 大海^{2, 4}

Masafumi SHIRAHAMA¹, Tomoko TANAKA^{1, 2}, Jouji KUKITA^{1, 2}, Yuichiro SHIMODA^{1, 2, 3}, Hiromi ISHIBASHI^{2, 4}

¹佐賀県立病院好生館内科, ²佐賀県立病院好生館小児科, ³佐賀県立病院好生館放射線科, ⁴九州大学医学部第1内科

¹Department of Internal Medicine, Saga Prefectural Hospital, ²Department of pediatrics, Saga Prefectural Hospital, ³Department of Radiology, Saga Prefectural Hospital, ⁴First Department of Internal Medicine, Faculty of Medicine, Kvushu University

キーワード : Color Doppler ultrasonography , Crohn's disease , Diagnosis, Disease activity

A 13-year-old boy was admitted with complaints of fever, epigastralgia, loss of appetite and loss of body weight of six-week duration. Initial laboratory examination showed inflammatory signs; gray-scale ultrasonography (US), marked thickening of the distal ileal wall; and color Doppler US scan, readily visible blood flow with arterial blood-flow signals in the diseased bowel wall. Subsequent barium study of the small bowel demonstrated edematous loop of the distal ileum with stenosis. Subjective symptoms, laboratory abnormalities and roentgenologic findings promptly improved after the start of treatment with intravenous hyperalimentation and oral prednisolone under a tentative diagnosis of Crohn's disease; abnormal gray-scale and color Doppler US appearances remained, however. The illness recurred after diminution of prednisolone and initiation of oral intake, and colonoscopy confirmed the final diagnosis of Crohn's disease. Gray-scale and Color Doppler US were useful in assessing disease activity in this case of Crohn's disease.