Gastroduodenitis associated with ulcerative colitis: A case report

Abstract

BACKGROUND Ulcerative colitis (UC) is defined as a chronic inflammatory bowel disease that can occur in any part of the large bowel. In addition, UC affects only the large bowel except for backwash ileitis and pouchitis, whereas Crohn's disease (CD) affects the entire digestive tract. Inflammatory bowel disease (IBD) patients tend to be diagnosed with CD or indeterminate colitis when combined with gastric lesion. However, in recent years, some UC patients are reported to have various degrees of lesions in gastroduodenum. Here, we report a case of gastroduodenitis associated with UC (GDUC). CASE SUMMARY A 25-year-old man with a history of Klippel-Trenaunay syndrome presented to the hospital with mucopurulent bloody stool and epigastric persistent colic pain for 2 wk. Continuous superficial ulcers and spontaneous bleeding were observed under colonoscopy. Subsequent gastroscopy revealed mucosa with diffuse edema, ulcers, errhysis, and granular and friable changes in the stomach and duodenal bulb, which were similar to the appearance of the rectum. After ruling out other possibilities according to a series of examinations, a diagnosis of GDUC was considered. The patient hesitated about intravenous corticosteroids, so he received a standardized treatment with pentasa of 3.2 g/d. After 0.5 mo of treatment, the patient’s symptoms achieved complete remission. Follow-up endoscopy and imaging findings showed no evidence of recurrence for 26 mo. CONCLUSION The occurrence of gastrointestinal involvement in UC is rare, which may open a new window for studying the etiology and pathogenesis of UC. Physicians should consider broad differential diagnosis by endoscopic biopsy and laboratory examinations.

Severe immune checkpoint inhibitor-associated gastritis: A case series and literature review

“…Differential diagnosis also includes gastric lesions such as in patients with ulcerative colitis. Endoscopic findings of erythematous and edematous mucosa with whitish purulent discharge may be observed in upper gastrointestinal lesions in patients with ulcerative colitis [30,31]. On pathological examination, the lesions show severe inflammation with sloughed epithelial cells, resembling a crypt abscess.…”

The Influence of the Hydrophobic Polymeric Coating on 5-ASA Release from the Bipolymeric Milibeads with Amidated Pectin

“…The last decade has brought more and more information about the changes in the stomach and duodenum accompanying ulcerative colitis. The use of a mesalazine preparation in which a part of the active ingredient is released in the stomach may favorably influence the course of treatment of complex inflammatory lesions within GT [ 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ]. The latest scientific articles link the inflammatory lesions in the duodenum or stomach with bowel inflammation [ 39 ], which suggests the regions of drug targeting.…”

Gastroduodenitis Associated with Active Ulcerative Colitis Treated with Infliximab: Different Clinical Course in the Colon and Gastroduodenal Lesions

“…All patients had GDUC/ UGDLs accompanied by pancolitis or a postproctocolectomy status (7,8). Regarding the clinical characteristics, the underlying colonic lesions were pathologically classified as active pancolitis, or the upper gastrointestinal tract lesions had developed after proctocolectomy when the lesions of the upper gastrointestinal tract were detected (4,7,9) In the literature review, several case reports have been published (Table) (5,(9)(10)(11)(12)(13)(14)(15)(16). In these cases, only four GDUC/UGDL cases had an unresected colon, and simultaneous evaluation of the colon and upper gastrointestinal tract was possible (5,15,16).…”