Multiple Mucosal Bridge Formation in the Esophagus in a Patient with Crohn's Disease

Honda, Satoshi; Sugimoto, Koji; Iwasaki, Hirohiko; Higuchi, Ryota; Kubota, Hidemoto; Watanabe, Fumio; Yoshii, Shunsuke; Hanai, Hiroyuki; Kaneko, Eizō

doi:10.1055/s-2007-1001267

Cited by 13 publications

(9 citation statements)

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“…5,6 Only one case with a mucosal bridge due to reflux esophagitis has been previously reported. 7 An acquired mucosal bridge due to inflammatory processes may arise anywhere from the esophagus to the colon.…”

Section: Discussionmentioning

confidence: 99%

Mucosal bridge due to reflux esophagitis

Kume

Yoshikawa

2009

Gastroenterol Insights

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A 28-year old man had congenital dysphagia due to intracerebral neurofibroma. He visited our hospital complaining of heartburn and occasional coffee residue-like vomiting for half a year. Esophagoscopy revealed a mucosal bridge in the middle part of the esophagus (Figure 1). This lesion was destroyed spontaneously by deeper insertion of the endoscope. Moreover, esophagoscopy showed linear mucosal breaks between the middle and lower body of the esophagus (Figure 2). Therefore, he was diagnosed as having a mucosal bridge due to reflux esophagitis

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Section: Discussionmentioning

confidence: 99%

Mucosal bridge due to reflux esophagitis

Kume

Yoshikawa

2009

Gastroenterol Insights

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“…The common mucosal findings in esophageal Crohn's disease include superficial aphthous ulcerations; deep, punched out, and linear ulcerations; and strictures [3]. Multiple mucosal bridges [49] and fistulous openings have been described as well [10]. Biopsies show a range of histology, including focal chronic inflammation with plasma cells and noncaseating granulomata [4].…”

Section: Upper Gi Endoscopymentioning

confidence: 99%

Crohn’s disease of the esophagus

Isaacs

2007

Curr Treat Options Gastro

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Esophageal damage is an uncommon manifestation of Crohn's disease. The diagnosis should be considered in patients who have other intestinal manifestations of Crohn's disease and present with esophageal symptoms. Diagnosis should be based on history, known extraesophageal Crohn's disease, endoscopic evaluation with biopsy, and exclusion of gastroesophageal reflux disease. Mild disease should be treated with acid suppression and a short course of steroids. 5-aminosalicylates are not likely to be effective due to drug release characteristics. Patients who have moderate to severe disease should be treated aggressively with acid suppression, a longer course of steroids, and consideration of immunosuppressive therapy with 6-mercaptopurine or azathioprine. Infliximab or other anti-tumor necrosis factor therapy also can be considered in refractory patients to try to prevent the complications of stricturing and fistula formation. In those patients who develop strictures of the esophagus, treatment with balloon dilatation of the stricture followed by injection of a long-acting steroid such as triamcinolone will help to alleviate symptoms. Surgery may be required for severe, refractory symptoms, but it has a high morbidity in this population.

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“…Consequently, routine upper GI tract endoscopic examination is recommended in the work up of such patients 485 . A number of complications of esophageal Crohn’s disease have been reported, including pulmonary 486 and stomach 487 fistulae, multiple mucosal bridges 488 and a 15‐cm long stricture 489…”

Section: Investigating the Esophagus (For Manometry See Esophageal Mmentioning

confidence: 99%