scholarly journals Upper Gastrointestinal Manifestations of Crohn’s Disease: Differential Diagnosis and Treatment of an Uncommon Presentation of Crohn’s Disease

2021 ◽  
Author(s):  
Ketan Mehta ◽  
Maria T Kurtz
Keyword(s):  
Differential Diagnosis ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Psychological Effects ◽  
Learning Objectives ◽  
Diagnosis And Treatment ◽  
Military Career ◽  
Uncommon Presentation ◽  
The Military ◽  
Upper Gastrointestinal

ABSTRACT Esophagogastroduodenoileal involvement of Crohn’s disease (CD) is uncommon; less than 5% of adult patients will suffer from this condition, although this diagnosis is likely underestimated given the lack of routine evaluation of the upper gastrointestinal tract in the absence of symptoms. An interesting differential, including sarcoidosis, eosinophilic gastroenteritis, tuberculosis, and Brunner’s gland hyperplasia, should be considered. The consequences of this diagnosis can have profound impacts on the military career of a soldier. Learning objectives of this case report include workup, differential, diagnosis, and treatment of esophagogastroduodenoileal involvement of CD, as well as discussing the psychological effects of this diagnosis and impact on an individual’s military career.

A case report of a patient with isolated Crohn’s disease of the stomach

2021 ◽  
Vol 19 (3) ◽  
pp. 95-101
Author(s):  
E.A. Trush ◽  
◽  
A.I. Ulyanin ◽  
A.V. Korolev ◽  
L.N. Androsova ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Clinical Symptoms ◽  
Granulomatous Inflammation ◽  
Endoscopic Finding ◽  
Disease Course ◽  
Morphological Examination ◽  
Gastric Biopsies ◽  
Upper Gastrointestinal

Crohn’s disease of the esophagus, stomach or duodenum is extremely rare and characterized by an aggressive disease course with a poor prognosis. Clinical symptoms of the upper gastrointestinal tract lesion are nonspecific, therefore esophagogastroduodenoscopy with biopsy is necessary for the differential diagnosis. Crohn’s disease of the stomach is characterized by a specific endoscopic finding – bamboo-joint-like appearance of gastric folds. Granulomatous inflammation in morphological examination of gastric biopsies in patients with Crohn’s disease is rare, therefore endoscopic finding is more pathognomonic. This article presents a clinical case of a patient with isolated Crohn’s disease of stomach, differential diagnosis and treatment approaches of the disease. Key words: Crohn’s disease, Crohn’s disease with lesions of the stomach, gastroprotective agents, proton pump inhibitors, endoscopic sonography

Postoperative Recurrence of Crohn's Disease: Pathophysiology, Diagnosis and Treatment

2018 ◽  
Vol 18 (12) ◽  
pp. 979-988 ◽  
Author(s):  
Antonio Di Sario ◽  
Paola Sassaroli ◽  
Luigi Daretti ◽  
Giulia Annulli ◽  
Laura Schiada ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Postoperative Recurrence ◽  
Diagnosis And Treatment

scholarly journals A Rare Case of Gastric Crohn’s Disease Complicated by Gastric Carcinoma

2018 ◽  
pp. 1-6
Author(s):  
Marwah Sami M Hussain ◽  
Bandar Idrees Ali ◽  
Abdullah Alzahrani
Keyword(s):  
Gastric Cancer ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Inflammatory Bowel Diseases ◽  
Rare Case ◽  
Small Bowel Adenocarcinoma ◽  
Disease Case ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Upper Gastrointestinal

Background: Inflammatory bowel diseases are strongly associated with colorectal cancer. In addition, a few cases reported with gastric and small bowel adenocarcinoma in gastroduodenal Crohn’s disease. Case report: We reported a case of a 47-Year-old female, who was referred to our surgical department and after a routine gastroscopy which revealed a lesion. Biopsy confirmed gastric well-differentiated adenocarcinoma of limited gastric Crohn’s disease, for a patient on regular anti Crohn’s medication. The patient underwent varying laparoscopic distal gastrectomy. She received adjuvant chemotherapy treatment and thereafter, she was cancer free within the period of 3- years of regular follow up. Conclusion: The only way to diagnose such lesions of a rare case of gastric cancer in a patient with Crohn’s disease is to regularly carry out upper gastrointestinal examinations. Keywords: Inflammatory bowel diseases, Crohn’s disease, Upper gastrointestinal tract Crohn’s disease, Gastric cancer

scholarly journals A Retrospective Evaluation of the Utility of Capsule Endoscopy and Double-Balloon Endoscopy in Crohn’s Disease

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Masanao Nakamura ◽  
Yoshiki Hirooka ◽  
Osamu Watanabe ◽  
Takeshi Yamamura ◽  
Kohei Funasaka ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Differential Diagnosis ◽  
Crohn’S Disease ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Capsule Endoscopy ◽  
Balloon Dilation ◽  
Retrospective Evaluation ◽  
Double Balloon Endoscopy ◽  
Double Balloon

Background. Although the usefulness of capsule endoscopy (CE) and double-balloon endoscopy (DBE) for the evaluation of Crohn’s disease (CD) is established, their capabilities in the differential diagnosis of small bowel stenosis have not been sufficiently addressed. The present study therefore aimed to retrospectively determine the types of patients for whom CE and DBE would confer the most benefit.Patients and Methods. We retrospectively reviewed data from 185 patients with established CD. A change of treatment based on CE or DBE results or successful DBE balloon dilation was defined as clinically useful indication. We then analyzed the factors significantly related to useful and poor indications.Results. CE results were assessed as useful indications in 28 (45%) of 62 patients. Multivariate analysis demonstrated that positive CRP and low IOIBD score are factors significantly related to a useful indication. DBE results were recognized as useful indications in 118 (77%) of 153 patients. Multivariate analysis indicated small bowel stenosis and abdominal pain as factors significantly associated with useful indications. All patients with a poor indication on CE had small bowel stenosis.Conclusions. CE was most useful for patients in clinical remission with positive CRP and without stenosis, whereas DBE was useful for patients with symptoms of stenosis.

scholarly journals Upper Gastrointestinal Crohn’s Disease: Literature Review and Case Presentation

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Soorya N. Aggarwal ◽  
Yana Cavanagh ◽  
Lan Wang ◽  
Amer Akmal ◽  
Matthew A. Grossman
Keyword(s):  
Crohn’S Disease ◽  
Gastrointestinal Tract ◽  
Iron Deficiency ◽  
Crohn's Disease ◽  
Fecal Calprotectin ◽  
Upper Gastrointestinal Tract ◽  
Laboratory Evaluation ◽  
Deficiency Anemia ◽  
Endoscopic Evaluation ◽  
Upper Gastrointestinal

Upper gastrointestinal tract predominant Crohn’s Disease (CD) remains an elusive clinical entity, manifesting limited or vague symptomatology, eluding clinical suspicion, and delaying subsequent diagnostic evaluation. As a result, it has not been widely described and there is a lack of clear recommendations for diagnosis or management. Standard IBD evaluation including serologic testing, imaging, and endoscopy may initially not be fruitful. Furthermore, endoscopic evaluation may be grossly normal in patients without long standing-disease. We describe an 18-year-old male who presented with only unexplained, persistent iron-deficiency anemia. Extensive outpatient testing including multiple endoscopic evaluations with standard biopsies was unfruitful. Ultimately, a positive fecal calprotectin prompted enteroscopy with endoscopic mucosal resection (EMR) in an effort to obtain a larger, deeper tissue specimen. Grossly cobblestoned mucosa along with histopathology revealing focal crypt abscesses, chronic inflammation in the lamina propria, and superficial foveolar epithelial regenerative changes were consistent with CD. This patient’s case illustrates the need for a high degree of suspicion for CD in patients with unexplained or persistent iron deficiency anemias. Persistent investigation yielded an elevation in fecal calprotectin suggesting underlying gastrointestinal inflammation and prompted advanced endoscopic evaluation with EMR. Waxing and waning tissue findings are characteristic of CD and pose a unique challenge in patients with upper gastrointestinal predominant pathology. As such, diligent workup including laboratory evaluation, imaging, and serial endoscopy is critical to establish pathology and dictate subsequent management in IBD, especially upper gastrointestinal tract predominant CD.

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