الفهرس 
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Abstract
Summary
Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) characterized by alternating periods of remission and relapse (Langholz et al., 1991).
During the last decade, bowel ultrasound (US) has become accepted as a primary imaging procedure in the diagnostic workup and follow-up of IBD (Horsthuiset al., 2008).
Gastrointestinal ultrasound (GIUS) offers an advantageous alternative due to its low cost, excellent safety profile and lack of need for bowel preparation. For these reasons, its ease of execution, ability and availability to be performed at the point- of-care by a gastroenterologist offer considerable advantages over endoscopy (Smith et al., 2020).
Transabdominal ultrasound is useful for the detection of bowel wall thickening and for determining the extent of involved segments in different kinds of inflammatory bowel diseases (Kucharzik et al., 2017).
In particular, diagnostic performance of bowel US in detecting inflammatory colonic disorders largely depends on the disease site: sensitivity is quite high for sigmoid / descending colonic localization (which reaches 97 % in UC) (Parente et al., 2003).
The aim of this study was to evaluate the usefulness of intestinal US in comparison to colonoscopy for assessing disease extent and activity of Ulcerative Colitis.
This was a cross sectional study which included 60 patients with ulcerative colitis who attended Gastroenterology outpatient clinics and IBD unit of National Hepatology and Tropical Medicine Research Institute. Participants were divided into 2 groups of patients according to Truelove and Witt’s criteria for classification of severity of ulcerative colitis.
• group I (n= 30) active ulcerative colitis patients.
• group II (n= 30) inactive ulcerative colitis patients (in remission).
Selected patients were subjected to proper history taking, complete clinical examination, laboratory investigations and intestinal ultrasound examination (IUS).
The main findings of the study revealed that:
• Active ulcerative colitis significantly increased in workers, but no statistical significant difference between studied groups was detected as regards other demographic data.
• The mean age at diagnosis was 36.8 (± 9.9 SD) in active ulcerative colitis patients and 38.1 (±9.8 SD) in inactive ulcerative colitis patients and according to Disease extent there were 20 patients (66.7%) with left-sided, 6 patients (20%) with extensive and 4 patients (13.3%) with pan-colitis in active ulcerative colitis patients and there were 23 patients (76.7%) with left-sided, 5 patients (16.7%) with extensive and 2 patients (6.7%) with pan-colitis in inactive ulcerative colitis patients.
• The abdominal tenderness, exaggerated abdominal sounds and abdominal distension increased in patients with active ulcerative colitis with high statistical significant difference, and pulse increased in patients with active ulcerative colitis with statistical significant difference, but no statistical significant difference between studied groups as regards temperature.
• There were highly statistical significant differences between the studied groups as regard Hb, WBCs, ESR, CRP and fecal calprotectin.
• There was highly statistical significant difference between the studied groups regarding bowel wall thickness, doppler signal and wall layer stratification, but no statistical significant difference between studied groups as regard fat creeping and reactive LNs.
• According to Endoscopic Activity Index there was highly statistical significant difference between studied groups.
• There was statistically significant difference between disease extent and doppler signal in active ulcerative colitis group but no statistical significant difference between disease extent and bowel wall thickness and wall layer stratification in active ulcerative colitis group.
• Also, there was highly statistical significant difference between disease extent & wall layer stratification in inactive ulcerative colitis group and statistically significant difference between disease extent & doppler signal in inactive ulcerative colitis group, but no statistical significant difference between disease extent & bowel wall thickness in inactive ulcerative colitis group.
• There was statistically significant difference between Endoscopic Activity Index and wall layer stratification in active ulcerative colitis group, but no statistical significant difference between Endoscopic Activity Index and bowel wall thickness and doppler signal in active ulcerative colitis group.
• There was highly statistical significant difference between Endoscopic Activity Index and Doppler signal and wall layer stratification in inactive ulcerative colitis group, but no statistical significant difference between Endoscopic Activity Index and bowel wall thickness in inactive ulcerative colitis group.
• Fecal calprotectin can be used to discriminate between active and inactive patients at a cut off level of > 222, with 76.7% sensitivity, 96.7% specificity, 95.9% positive predictive value and 80.6% negative predictive value.
• In active ulcerative colitis group there were statistically significant positive correlation between fecal calprotectin and ESR and no statistical significant correlation between fecal calprotectin level and other studied quantitative data. But in inactive ulcerative colitis group there were no statistical significant correlation between fecal calprotectin level and other studied quantitative data.
• Bowel wall thickness can be used to discriminate between active and inactive ulcerative colitis patients at a cut off level of > 3.5, with 100% sensitivity, 100% specificity, 100% positive predictive value and 100% negative predictive value.
• In active ulcerative colitis patients there was no statistically significant correlation between bowel wall thickness and other studied data in active group. But in inactive ulcerative colitis patients there were statistically significant positive correlation between bowel wall thickness and age of patients and statistically significant positive correlation between bowel wall thickness and age at diagnosis of patients.