Background Previous research has shown that transabdominal bowel ultrasound (TABUS) can detect disease in inflammatory bowel disease (IBD) patients. Aims Our aim is to determine the parameters of bowel ultrasound findings that are associated with disease severity at time of diagnosis. Methods This prospective study was conducted at the Stollery Children's Hospital in Edmonton, Alberta. Patients with suspect IBD were enrolled. Each patient underwent a baseline ultrasound, Physicians performed

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... US to visualize the small and large intestine (except rectum). Other investigations including blood work, MRI, and endoscopy. Disease severity in was categorised into mild, moderate and severe using the weighted pediatric Crohn's disease activity index (wPCDAI), simple endoscopic score for CD (SES-CD), pediatric ulcerative colitis disease activity index (PUCAI), and Mayo score in UC. The severity of disease was compared to 7 ultrasound parameters (fat proliferation, hyperemia, bowel wall thickness (BWT), free intra- abdominal fluid, > 4 lymph nodes (LN) in an area, presence of stricture, and BW stratification. Data was analyzed using SPSS. Anova and Chi square were used to determine parameters for TABUS that were associated with disease severity, with p <0.05 considered significant. Results This prospective study was conducted at the Stollery Children's Hospital in Edmonton, Alberta. Patients with suspect IBD were enrolled. Each patient underwent a baseline ultrasound, Physicians performed TABUS to visualize the small and large intestine (except rectum). Other investigations including blood work, MRI, and endoscopy. Disease severity in was categorised into mild, moderate and severe using the weighted pediatric Crohn's disease activity index (wPCDAI), simple endoscopic score for CD (SES-CD), pediatric ulcerative colitis disease activity index (PUCAI), and Mayo score in UC. The severity of disease was compared to 7 ultrasound parameters (fat proliferation, hyperemia, bowel wall thickness (BWT), free intra- abdominal fluid, > 4 lymph nodes (LN) in an area, presence of stricture, and BW stratification. Data was analyzed using SPSS. Anova and Chi square were used to determine parameters for TABUS that were associated with disease severity, with p <0.05 considered significance. Conclusions Fat proliferation was found to be associated with severity of Crohn's disease based on disease activity score while BWT was associated with endoscopic severity. Lack of association in UC is likely due to the low number of patients recruited. Funding Agencies WCHRI Capacity Grant