Nonspecific involvement of bowel adjoining Crohn disease.

Nonspecific changes in bowel segments adjacent to areas of Crohn disease were identified radiographically in 12 patients. In eight patients such changes were related to fistulization; in four patients they were due to close proximity of an inflammatory mass, abscess, or phlegmon of Crohn disease origin. The radiographic feature of nonspecific involvement was focal fold thickening, either in relation to the site of entry of fistulas or, together with mass effect, in response to the extrinsic inflammatory process. Radiographic differentiation of nonspecific bowel changes from actual Crohn disease is possible and is relevant to management, since nonspecific changes revert to normal once the underlying Crohn disease has been resected. Preoperative identification of nonspecificity supports a more conservative approach to surgery in patients with Crohn disease.