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
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.