An unusual case of Crohn's disease with isolated gastric involvement

Ingle, Sachin B; Pujari, Ganesh P.; Patle, Yogesh G.; Nagoba, Basavraj

doi:10.1016/j.crohns.2010.10.001

Cited by 8 publications

(4 citation statements)

References 9 publications

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“…This is not unique among upper gastrointestinal Crohn's disease cases; however, this case is unlike other cases to our knowledge due to the rapid onset of symptoms of gastric outlet obstruction with no long history of gastritis-like symptoms. Documented cases of isolated upper gastrointestinal Crohn's disease typically present with gastritis-like epigastric pain progressing over a number of years [ 7 – 9 ]. Symptoms of gastric outlet obstruction (bloating, vomiting, postprandial pain and weight loss) evolve in many cases, but almost universally after years of gastritis-like symptoms.…”

Section: Discussionmentioning

confidence: 99%

Crohn's disease presenting as gastric outlet obstruction

Scheck

Ram

Loveday

et al. 2014

Journal of Surgical Case Reports

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We present a unique presentation of Crohn's disease in a 25-year-old male with a 3-month history of progressive gastric outlet obstruction symptoms including reflux, vomiting, postprandial pain and weight loss, with no other symptoms. Multiple imaging investigations as well as gastroscopic biopsies revealed a non-specific prepyloric lesion, without evidence of malignancy. A distal gastrectomy was performed. Subsequent histological evaluation revealed gastroduodenal Crohn's disease. Follow-up revealed no evidence of disease elsewhere in the gastrointestinal system or systemically. While it is not uncommon for Crohn's disease to involve the stomach and duodenum, it is rare for gastroduodenal disease to be the initial presentation. Isolated gastroduodenal Crohn's disease typically presents with non-specific gastritis-like symptoms over a number of years. This patient had a unique course of Crohn's disease with rapid onset of symptoms, predominantly relating to gastric outlet obstruction and no prior or subsequent history of gastrointestinal symptoms.

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Section: Discussionmentioning

confidence: 99%

Crohn's disease presenting as gastric outlet obstruction

Scheck

Ram

Loveday

et al. 2014

Journal of Surgical Case Reports

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“…Gastroduodenal CD is reported in 0.5 to 4.0% of all CD cases ( 8–11 ). Isolated gastric involvement is rare, affecting less than 0.07% of all CD cases ( 12 ). Almost 60% of patients with gastroduodenal CD have had previous inflammation elsewhere in the GI tract, and one-third of patients with isolated upper GI CD (UGI-CD) at diagnosis will develop distal disease later in life ( 8 , 10 , 13 ).…”

Section: Review Of Literaturementioning

confidence: 99%

“…UGI-CD is diagnosed based on a combination of clinical presentation, biochemical signs of inflammation, and endoscopic evaluation with biopsy and histopathological evaluation ( 12 , 15 ). Nugent and Roy grouped these investigations and formulated diagnostic criteria for gastroduodenal CD: (1) demonstration of non-caseating granulomatous inflammation in the stomach or duodenum in the absence of other systemic granulomatous disorders, with or without more distal intestinal inflammation; (2) endoscopic or radiographic findings of diffuse inflammation in the stomach or duodenum consistent with CD in a patient with confirmed CD of the GI tract ( 11 ).…”

Section: Review Of Literaturementioning

confidence: 99%

Case report and review of literature: IgG4-gastroduodenitis in upper GI Crohn’s disease: two separate entities or just a marker of disease severity?

Desmedt,

Geldof,

Hoorens

et al. 2024

Front. Med.

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A 20-year-old man was presented with ulcerative gastritis and duodenitis complicated by pyloric stenosis. Helicobacter pylori infection was excluded, and the lesions did not respond to treatment with proton pump inhibitors. No other parts of the intestinal tract showed signs of inflammation. Histopathological review showed signs of chronic inflammation with granuloma formation. A tentative diagnosis of isolated upper gastrointestinal (UGI) Crohn’s disease was performed. However, additional work-up revealed significantly positive IgG4 staining as well as elevated IgG4 serum levels. Since granulomatous disease is unlikely in IgG4-related disease, an eventual diagnosis of overlapping IgG4-related disease and Crohn’s disease (CD) was performed. Treatment with systemic steroids and anti-TNF in combination with azathioprine led to rapid symptomatic improvement. In this article, we review the available literature on IgG4-related gastroduodenitis, granulomatous gastritis, and upper GI CD. We suggest the possibility that IgG4-infiltration may be a marker of severely active inflammatory bowel disease rather than a separate disease entity.

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“…Gastroduodenal CD affects 0.5–4% of all CD patients [ 4 ], with the majority of such patients having concurrent involvement of the colon with isolated gastroduodenal involvement accounting for less than 0.07% of all CD patients [ 5 , 6 ]. Pathology is more obscure in the upper GI tract, and noncaseating granulomas are not necessarily needed for confirmatory diagnosis.…”

Section: Introductionmentioning

confidence: 99%

An Obscure Presence of Gastroduodenal Involvement in a Newly Diagnosed Ileocolonic Crohn’s Disease Patient

Miranda

Ali

Ayaz

et al. 2022

Case Reports in Gastrointestinal Medicine

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Whereas typical Crohn’s disease is confined to the terminal ileum and presents with abdominal pain and diarrhea, gastroduodenal manifestations of Crohn’s disease are rare, with often asymptomatic patient presentations and inconclusive diagnostic testing. It is, however, a more severe form of Crohn’s disease and thus warrants treatment with steroids and biologics much earlier than its ileocolonic counterpart. We present the case of a young, otherwise healthy, male with newly diagnosed ileocolonic Crohn’s disease with concurrent gastroduodenal involvement that initially failed management with biologic agents. We discuss the clinical manifestations and often obscure pathology of gastroduodenal Crohn’s disease and highlight the necessity of performing a concurrent esophagogastroduodenoscopic evaluation on newly diagnosed ileocolonic Crohn’s disease to assess the presence of upper gastrointestinal involvement.

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An unusual case of Crohn's disease with isolated gastric involvement

Cited by 8 publications

References 9 publications

Crohn's disease presenting as gastric outlet obstruction

Crohn's disease presenting as gastric outlet obstruction

Case report and review of literature: IgG4-gastroduodenitis in upper GI Crohn’s disease: two separate entities or just a marker of disease severity?

An Obscure Presence of Gastroduodenal Involvement in a Newly Diagnosed Ileocolonic Crohn’s Disease Patient

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