Authors (including presenting author) :
Cheng TF(1), Ma YK(1), Cheng KS(1), Li KK(1)
Affiliation :
(1)Division of Gastroenterology and Hepatology, Department of Medicine and Geriatrics, Tuen Mun Hospital
Keyword 1: :
Intestinal ultrasound
Keyword 2: :
inflammatory bowel disease
Keyword 3: :
improve clinical care
Keyword 4: :
point-of-care assessment
Introduction :
Incidence of inflammatory bowel disease (IBD) is growing rapidly in Hong Kong with 30-fold increase in past 30 years from recent local epidemiological study. IBD mainly affects young to middle-aged adults with significant impact on their quality of life. We now have many advanced therapies including biologic agents and small molecules to treat IBD patients. It is important for us to have accurate and timely assessment in diagnosis, treatment response and flare. Modalities like ileo-colonoscopy and magnetic resonance enterography (MRE) are conventionally used. However, waiting times of these investigations in public hospitals are typically at least 1-2 years which may affect prognosis of IBD patients. Intestinal ultrasound (IUS) is a novel non-invasive tool to detect bowel inflammation by evaluating bowel wall thickness and vascularity, as well as complications of IBD like stricture and fistula. It can provide point-of care assessment to IBD patients in clinic and ward. Studies showed IUS has comparable accuracy as MRE and highly correlated to endoscopic bowel inflammation. Recent European guideline also regards IUS as monitoring tool for IBD patients in diagnosis, treatment response and flare. IUS service was started in Tuen Mun Hospital (TMH) since 1/2025.
Objectives :
To evaluate clinical outcomes in patients received IUS
Methodology :
Patients received IUS from January to December 2025 in TMH were evaluated. Their medical records including IUS findings, treatment response and medications including advanced therapies were reviewed.
Result & Outcome :
There were 197 IUS performed in 153 patients including 77 patients with Crohn’s disease, 63 patients with ulcerative colitis and 13 patients with suspected IBD. There were 7 patients from paediatrics. For indication, 72 scans were for suspected flare, 55 scans were for follow-up after flare, 57 scans were for disease monitoring. Most of IUS (88%) was performed as out-patient setting. Among those with suspected flare, 54 (75%) had active disease and 43 (80%) of them required treatment escalation including use of topical/oral steroid (n=31), initiate, optimize or change in immunomodulator (n=8) or advanced therapies (n=15). Among those for follow-up after flare, 39 (71%) showed improvement or remission after treatment, 16 (29%) still had active disease and 10 (63%) required treatment escalation. Among those for disease monitoring, 16 (28%) had active disease despite clinically in remission. There are 6 patients required arrangement of double-balloon enteroscopy for stricture dilatation based on IUS findings.
In conclusion, IUS can provide timely point-of-care assessment for IBD patients to allow gastroenterologists to make early treatment decision to optimize clinical outcomes.
