IDDF2021-ABS-0060 Comparison of clinical outcomes between radiological and endoscopic strictures in crohn’s disease: which types of bowel strictures require more attention from clinician?

BackgroundThe definition of ‘bowel stricture’ in Crohn’s disease (CD) is not uniform across studies, including radiological strictures (RS) and endoscopic strictures (ES). Few studies reported the differences of clinical outcomes between RS and ES in CD. Moreover, whether upstream dilatation (UD) is necessary to diagnosis RS remains unknown. We aimed to compare the clinical outcomes between RS and ES, for exploring which type of stricture requires more attention from clinicians and the significance of UD in RS.MethodsThis retrospective study enrolled 431 strictures which simultaneously underwent endoscopy and radiologic examinations. ES was defined as an endoscopic non-passable stricture; RS was defined as a luminal narrowing (at least 50% decrease) with wall thickening (at least 25% increase) relative to adjacent normal gut on CT/MRI. The strictures were categorized as Group 1 (G1, only met RS definition; further divided into G1a [without UD] or G1b [with UD]), Group 2 (G2, only met ES definition), or Group 3 (G3, met the definitions of RS and ES). Clinical adverse outcomes (CAO) referred to stricture-related surgery or penetrating diseases. The follow-up endpoint was the time occurring CAO or November 30, 2020, if absent of CAO.ResultsG1b (65.0%) had the highest occurrence rate of CAO, followed by G3 (40.4%), G1a (12.6%), and G2 (4%) (P