Download PDF
Clin Colon Rectal Surg 2019; 32(04): 231-242
DOI: 10.1055/s-0039-1683850
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Crohn's Disease of the Esophagus, Duodenum, and Stomach

David M. Schwartzberg
1   Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio
,
Stephen Brandstetter
1   Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio
,
Alexis L. Grucela
2   Division of Colon and Rectal Surgery, New York University Langone Medical Center, New York, New York
› Author Affiliations
Further Information

Publication History

Publication Date:
17 June 2019 (online)

   Permissions and Reprints

Abstract

Upper gastrointestinal Crohn's is an under-reported, under-recognized phenotype of Crohn's disease. Routine screening in the pediatric population has shown a higher prevalence compared with adults; however, most adult patients remain asymptomatic with respect to upper gastrointestinal Crohn's disease. For the patients who are symptomatic, medical treatment is the first line of management, except for cases of obstruction, perforation, or bleeding. Though most patients respond to medical therapy, mainly steroids, with the addition of immunomodulators and more recently biologics agents, surgical intervention is usually required only for obstructing gastroduodenal disease secondary to strictures. Strictureplasty and bypass are safe operations with comparable morbidity, although bypass has higher rates of dumping syndrome and marginal ulceration in the long term. Rare cases of gastroduodenal fistulous disease from active distal disease may involve the stomach or duodenum, and esophageal Crohn's disease can fistulize to surrounding structures in the mediastinum which may require the highly morbid esophagectomy.

Keywords

Upper Gastrointestinal Crohn's Disease - gastroduodenal Crohn's disease - esophageal Crohn's disease - strictureplasty
 

  • References

  • 1 Comfort MW, Weber HM, Baggenstoss AH, Kiely WF. Nonspecific granulomatous inflammation of the stomach and duodenum; its relation to regional enteritis. Am J Med Sci 1950; 220 (06) 616-632
    CrossrefPubMedGoogle Scholar
  • 2 Crohn BB, Ginzburg L, Oppenheimer GD. Landmark article Oct 15, 1932. Regional ileitis. A pathological and clinical entity. By Burril B. Crohn, Leon Ginzburg, and Gordon D. Oppenheimer. JAMA 1984; 251 (01) 73-79
    CrossrefPubMedGoogle Scholar
  • 3 Reynolds Jr HL, Stellato TA. Crohn's disease of the foregut. Surg Clin North Am 2001; 81 (01) 117-135 , viii
    CrossrefPubMedGoogle Scholar
  • 4 Goldstein NS, Lewin KJ, Doty JE. Gastrointestinal tract. Pathology (Phila) 1996; 3 (02) 349-365
    PubMedGoogle Scholar
  • 5 Loftus Jr EV, Schoenfeld P, Sandborn WJ. The epidemiology and natural history of Crohn's disease in population-based patient cohorts from North America: a systematic review. Aliment Pharmacol Ther 2002; 16 (01) 51-60
    CrossrefPubMedGoogle Scholar
  • 6 Loftus Jr EV. Update on the incidence and prevalence of inflammatory bowel disease in the United States. Gastroenterol Hepatol (N Y) 2016; 12 (11) 704-707
    PubMedGoogle Scholar
  • 7 Bousvaros A, Antonioli DA, Colletti RB. , et al; North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition; Colitis Foundation of America. Differentiating ulcerative colitis from Crohn disease in children and young adults: report of a working group of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the Crohn's and Colitis Foundation of America. J Pediatr Gastroenterol Nutr 2007; 44 (05) 653-674
    CrossrefPubMedGoogle Scholar
  • 8 Kappelman MD, Rifas-Shiman SL, Kleinman K. , et al. The prevalence and geographic distribution of Crohn's disease and ulcerative colitis in the United States. Clin Gastroenterol Hepatol 2007; 5 (12) 1424-1429
    CrossrefPubMedGoogle Scholar
  • 9 Sandler RS, Everhart JE, Donowitz M. , et al. The burden of selected digestive diseases in the United States. Gastroenterology 2002; 122 (05) 1500-1511
    CrossrefPubMedGoogle Scholar
  • 10 Goodhand J, Dawson R, Hefferon M. , et al. Inflammatory bowel disease in young people: the case for transitional clinics. Inflamm Bowel Dis 2010; 16 (06) 947-952
    CrossrefPubMedGoogle Scholar
  • 11 Wagtmans MJ, Verspaget HW, Lamers CB, van Hogezand RA. Clinical aspects of Crohn's disease of the upper gastrointestinal tract: a comparison with distal Crohn's disease. Am J Gastroenterol 1997; 92 (09) 1467-1471
    PubMedGoogle Scholar
  • 12 Aloi M, Lionetti P, Barabino A. , et al; SIGENP IBD Group. Phenotype and disease course of early-onset pediatric inflammatory bowel disease. Inflamm Bowel Dis 2014; 20 (04) 597-605
    CrossrefPubMedGoogle Scholar
  • 13 Ammoury RF, Pfefferkorn MD. Significance of esophageal Crohn disease in children. J Pediatr Gastroenterol Nutr 2011; 52 (03) 291-294
    CrossrefPubMedGoogle Scholar
  • 14 Renault M, Goodier A, Subramony C, Hood B, Bishop P, Nowicki M. Age-related differences in granulomatous gastritis: a retrospective, clinicopathological analysis. J Clin Pathol 2010; 63 (04) 347-350
    CrossrefPubMedGoogle Scholar
  • 15 Horjus Talabur Horje CS, Meijer J, Rovers L, van Lochem EG, Groenen MJM, Wahab PJ. Prevalence of upper gastrointestinal lesions at primary diagnosis in adults with inflammatory bowel disease. Inflamm Bowel Dis 2016; 22 (08) 1896-1901
    CrossrefPubMedGoogle Scholar
  • 16 Alcántara M, Rodriguez R, Potenciano JL, Carrobles JL, Muñoz C, Gomez R. Endoscopic and bioptic findings in the upper gastrointestinal tract in patients with Crohn's disease. Endoscopy 1993; 25 (04) 282-286
    Article in Thieme ConnectPubMedGoogle Scholar
  • 17 Kefalas CH. Gastroduodenal Crohn's disease. Proc (Bayl Univ Med Cent) 2003; 16 (02) 147-151
    PubMedGoogle Scholar
  • 18 Song X-M, Gao X, Li M-Z. , et al. Clinical features and risk factors for primary surgery in 205 patients with Crohn's disease: analysis of a South China cohort. Dis Colon Rectum 2011; 54 (09) 1147-1154
    CrossrefPubMedGoogle Scholar
  • 19 Murray JJ, Schoetz Jr DJ, Nugent FW, Coller JA, Veidenheimer MC. Surgical management of Crohn's disease involving the duodenum. Am J Surg 1984; 147 (01) 58-65
    CrossrefPubMedGoogle Scholar
  • 20 Sakuraba A, Iwao Y, Matsuoka K. , et al. Endoscopic and pathologic changes of the upper gastrointestinal tract in Crohn's disease. BioMed Res Int 2014; 2014 (03) 610767-6
    PubMedGoogle Scholar
  • 21 Ueno F, Matsui T, Matsumoto T, Matsuoka K, Watanabe M, Hibi T. ; Guidelines Project Group of the Research Group of Intractable Inflammatory Bowel Disease subsidized by the Ministry of Health, Labour and Welfare of Japan and the Guidelines Committee of the Japanese Society of Gastroenterology. Evidence-based clinical practice guidelines for Crohn's disease, integrated with formal consensus of experts in Japan. J Gastroenterol 2013; 48 (01) 31-72
    CrossrefPubMedGoogle Scholar
  • 22 Castellaneta SP, Afzal NA, Greenberg M. , et al. Diagnostic role of upper gastrointestinal endoscopy in pediatric inflammatory bowel disease. J Pediatr Gastroenterol Nutr 2004; 39 (03) 257-261
    CrossrefPubMedGoogle Scholar
  • 23 Tobin JM, Sinha B, Ramani P, Saleh AR, Murphy MS. Upper gastrointestinal mucosal disease in pediatric Crohn disease and ulcerative colitis: a blinded, controlled study. J Pediatr Gastroenterol Nutr 2001; 32 (04) 443-448
    CrossrefPubMedGoogle Scholar
  • 24 Levine YY, Koletzko J, Turner D. ESPGHAN revised Porto criteria for the diagnosis of inflammatory bowel disease in children and adolescents [in Chinese]. Zhonghua Er Ke Za Zhi 2016; 54 (10) 728-732
    PubMedGoogle Scholar
  • 25 Freeman HJ. Application of the Vienna Classification for Crohn's disease to a single clinician database of 877 patients. Can J Gastroenterol 2001; 15 (02) 89-93
    CrossrefPubMedGoogle Scholar
  • 26 Nugent FW, Richmond M, Park SK. Crohn's disease of the duodenum. Gut 1977; 18 (02) 115-120
    CrossrefPubMedGoogle Scholar
  • 27 Satsangi J, Silverberg MS, Vermeire S, Colombel JF. The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications. Gut 2006; 55 (06) 749-753
    CrossrefPubMedGoogle Scholar
  • 28 Gasche C, Scholmerich J, Brynskov J. , et al. A simple classification of Crohn's disease: report of the Working Party for the World Congresses of Gastroenterology, Vienna 1998. Inflamm Bowel Dis 2000; 6 (01) 8-15
    CrossrefPubMedGoogle Scholar
  • 29 Arnott IDR, Landers CJ, Nimmo EJ. , et al. Sero-reactivity to microbial components in Crohn's disease is associated with disease severity and progression, but not NOD2/CARD15 genotype. Am J Gastroenterol 2004; 99 (12) 2376-2384
    CrossrefPubMedGoogle Scholar
  • 30 Forcione DG, Rosen MJ, Kisiel JB, Sands BE. Anti-Saccharomyces cerevisiae antibody (ASCA) positivity is associated with increased risk for early surgery in Crohn's disease. Gut 2004; 53 (08) 1117-1122
    CrossrefPubMedGoogle Scholar
  • 31 Ferrante M, Henckaerts L, Joossens M. , et al. New serological markers in inflammatory bowel disease are associated with complicated disease behaviour. Gut 2007; 56 (10) 1394-1403
    CrossrefPubMedGoogle Scholar
  • 32 Vasiliauskas EA, Kam LY, Karp LC, Gaiennie J, Yang H, Targan SR. Marker antibody expression stratifies Crohn's disease into immunologically homogeneous subgroups with distinct clinical characteristics. Gut 2000; 47 (04) 487-496
    CrossrefPubMedGoogle Scholar
  • 33 Papp M, Altorjay I, Dotan N. , et al; Hungarian IBD Study Group. New serological markers for inflammatory bowel disease are associated with earlier age at onset, complicated disease behavior, risk for surgery, and NOD2/CARD15 genotype in a Hungarian IBD cohort. Am J Gastroenterol 2008; 103 (03) 665-681
    CrossrefPubMedGoogle Scholar
  • 34 Gottlieb C, Alpert S. Regional jejunitis. AJR Am J Roentgenol 1937; 38: 881-883
    PubMedGoogle Scholar
  • 35 Ross TM, Fazio VW, Farmer RG. Long-term results of surgical treatment for Crohn's disease of the duodenum. Ann Surg 1983; 197 (04) 399-406
    CrossrefPubMedGoogle Scholar
  • 36 Yamamoto T, Bain IM, Connolly AB, Keighley MR. Gastroduodenal fistulas in Crohn's disease: clinical features and management. Dis Colon Rectum 1998; 41 (10) 1287-1292
    CrossrefPubMedGoogle Scholar
  • 37 Turner D, Griffiths AM. Esophageal, gastric, and duodenal manifestations of IBD and the role of upper endoscopy in IBD diagnosis. Curr Gastroenterol Rep 2009; 11 (03) 234-237
    CrossrefPubMedGoogle Scholar
  • 38 Rutgeerts P, Onette E, Vantrappen G, Geboes K, Broeckaert L, Talloen L. Crohn's disease of the stomach and duodenum: a clinical study with emphasis on the value of endoscopy and endoscopic biopsies. Endoscopy 1980; 12 (06) 288-294
    Article in Thieme ConnectPubMedGoogle Scholar
  • 39 Nugent FW, Roy MA. Duodenal Crohn's disease: an analysis of 89 cases. Am J Gastroenterol 1989; 84 (03) 249-254
    PubMedGoogle Scholar
  • 40 Roka K, Roma E, Stefanaki K, Panayotou I, Kopsidas G, Chouliaras G. The value of focally enhanced gastritis in the diagnosis of pediatric inflammatory bowel diseases. J Crohn's Colitis 2013; 7 (10) 797-802
    PubMedGoogle Scholar
  • 41 Yamamoto T, Bain IM, Connolly AB, Allan RN, Keighley MR. Outcome of strictureplasty for duodenal Crohn's disease. Br J Surg 1999; 86 (02) 259-262
    CrossrefPubMedGoogle Scholar
  • 42 Pichney LS, Fantry GT, Graham SM. Gastrocolic and duodenocolic fistulas in Crohn's disease. J Clin Gastroenterol 1992; 15 (03) 205-211
    CrossrefPubMedGoogle Scholar
  • 43 Van Patter WN, Bargen JA, Dockerty MB, Feldman WH, Mayo CW, Waugh JM. Regional enteritis. Gastroenterology 1954; 26 (03) 347-450
    CrossrefPubMedGoogle Scholar
  • 44 Greenstein AJ, Present DH, Sachar DB. , et al. Gastric fistulas in Crohn's disease. Report of cases. Dis Colon Rectum 1989; 32 (10) 888-892
    CrossrefPubMedGoogle Scholar
  • 45 Wilk PJ, Fazio V, Turnbull Jr RB. The dilemma of Crohn's disease: ileosigmoidal fistula complicating Crohn's disease. Dis Colon Rectum 1977; 20 (05) 387-392
    CrossrefPubMedGoogle Scholar
  • 46 Yamamoto T, Fazio VW, Tekkis PP. Safety and efficacy of strictureplasty for Crohn's disease: a systematic review and meta-analysis. Dis Colon Rectum 2007; 50 (11) 1968-1986
    CrossrefPubMedGoogle Scholar
  • 47 Jacobson IM, Schapiro RH, Warshaw AL. Gastric and duodenal fistulas in Crohn's disease. Gastroenterology 1985; 89 (06) 1347-1352
    CrossrefPubMedGoogle Scholar
  • 48 Isaacs KL. Upper gastrointestinal tract endoscopy in inflammatory bowel disease. Gastrointest Endosc Clin N Am 2002; 12 (03) 451-462 , vii
    CrossrefPubMedGoogle Scholar
  • 49 Lenaerts C, Roy CC, Vaillancourt M, Weber AM, Morin CL, Seidman E. High incidence of upper gastrointestinal tract involvement in children with Crohn disease. Pediatrics 1989; 83 (05) 777-781
    PubMedGoogle Scholar
  • 50 Podugu A, Tandon K, Castro FJ. Crohn's disease presenting as acute gastrointestinal hemorrhage. World J Gastroenterol 2016; 22 (16) 4073-4078
    CrossrefPubMedGoogle Scholar
  • 51 Oto A, Zhu F, Kulkarni K, Karczmar GS, Turner JR, Rubin D. Evaluation of diffusion-weighted MR imaging for detection of bowel inflammation in patients with Crohn's disease. Acad Radiol 2009; 16 (05) 597-603
    CrossrefPubMedGoogle Scholar
  • 52 Punwani S, Rodriguez-Justo M, Bainbridge A. , et al. Mural inflammation in Crohn disease: location-matched histologic validation of MR imaging features. Radiology 2009; 252 (03) 712-720
    CrossrefPubMedGoogle Scholar
  • 53 Kiryu S, Dodanuki K, Takao H. , et al. Free-breathing diffusion-weighted imaging for the assessment of inflammatory activity in Crohn's disease. J Magn Reson Imaging 2009; 29 (04) 880-886
    CrossrefPubMedGoogle Scholar
  • 54 Maccioni F, Viscido A, Broglia L. , et al. Evaluation of Crohn disease activity with magnetic resonance imaging. Abdom Imaging 2000; 25 (03) 219-228
    CrossrefPubMedGoogle Scholar
  • 55 Wagtmans MJ, van Hogezand RA, Griffioen G, Verspaget HW, Lamers CB. Crohn's disease of the upper gastrointestinal tract. Neth J Med 1997; 50 (02) S2-S7
    CrossrefPubMedGoogle Scholar
  • 56 Farman J, Faegenburg D, Dallemand S, Chen CK. Crohn's disease of the stomach: the “ram's horn” sign. Am J Roentgenol Radium Ther Nucl Med 1975; 123 (02) 242-251
    CrossrefPubMedGoogle Scholar
  • 57 Annunziata ML, Caviglia R, Papparella LG, Cicala M. Upper gastrointestinal involvement of Crohn's disease: a prospective study on the role of upper endoscopy in the diagnostic work-up. Dig Dis Sci 2012; 57 (06) 1618-1623
    CrossrefPubMedGoogle Scholar
  • 58 Matsumura M, Matsui T, Hatakeyama S. , et al. Prevalence of Helicobacter pylori infection and correlation between severity of upper gastrointestinal lesions and H. pylori infection in Japanese patients with Crohn's disease. J Gastroenterol 2001; 36 (11) 740-747
    CrossrefPubMedGoogle Scholar
  • 59 Antonini F, Pezzilli R, Angelelli L, Macarri G. Pancreatic disorders in inflammatory bowel disease. World J Gastrointest Pathophysiol 2016; 7 (03) 276-282
    CrossrefPubMedGoogle Scholar
  • 60 Weber P, Seibold F, Jenss H. Acute pancreatitis in Crohn's disease. J Clin Gastroenterol 1993; 17 (04) 286-291
    CrossrefPubMedGoogle Scholar
  • 61 Song DJ, Whang IS, Choi HW, Jeong CY, Jung SH. Crohn's disease confined to the duodenum: a case report. World J Clin Cases 2016; 4 (06) 146-150
    PubMedGoogle Scholar
  • 62 Spiess SE, Braun M, Vogelzang RL, Craig RM. Crohn's disease of the duodenum complicated by pancreatitis and common bile duct obstruction. Am J Gastroenterol 1992; 87 (08) 1033-1036
    PubMedGoogle Scholar
  • 63 Fujiya M, Sakatani A, Dokoshi T. , et al. A bamboo joint-like appearance is a characteristic finding in the upper gastrointestinal tract of Crohn's disease patients: a case-control study. Medicine (Baltimore) 2015; 94 (37) e1500
    PubMedGoogle Scholar
  • 64 Lin J, McKenna BJ, Appelman HD. Morphologic findings in upper gastrointestinal biopsies of patients with ulcerative colitis: a controlled study. Am J Surg Pathol 2010; 34 (11) 1672-1677
    CrossrefPubMedGoogle Scholar
  • 65 Ikeuchi H, Hori K, Nishigami T. , et al. Diffuse gastroduodenitis and pouchitis associated with ulcerative colitis. World J Gastroenterol 2006; 12 (36) 5913-5915
    CrossrefPubMedGoogle Scholar
  • 66 Ikeuchi H, Hori K, Takashi Nishigami. , et al. Diffuse gastroduodenitis and pouchitis associated with ulcerative colitis. World J Gastroenterol 2006; 12 (36) 5913-5915
    CrossrefPubMedGoogle Scholar
  • 67 Hisabe T, Matsui T, Miyaoka M. , et al. Diagnosis and clinical course of ulcerative gastroduodenal lesion associated with ulcerative colitis: possible relationship with pouchitis. Dig Endosc 2010; 22 (04) 268-274
    CrossrefPubMedGoogle Scholar
  • 68 Rogler G. Top-down or step-up treatment in Crohn's disease?. Dig Dis 2013; 31 (01) 83-90
    CrossrefPubMedGoogle Scholar
  • 69 Mottet C, Juillerat P, Gonvers J-J. , et al. Treatment of gastroduodenal Crohn's disease. Digestion 2005; 71 (01) 37-40
    CrossrefPubMedGoogle Scholar
  • 70 Tremaine WJ. Gastroduodenal Crohn's disease: medical management. Inflamm Bowel Dis 2003; 9 (02) 127-128 , discussion 131
    CrossrefPubMedGoogle Scholar
  • 71 Korelitz BI, Adler DJ, Mendelsohn RA, Sacknoff AL. Long-term experience with 6-mercaptopurine in the treatment of Crohn's disease. Am J Gastroenterol 1993; 88 (08) 1198-1205
    PubMedGoogle Scholar
  • 72 Griffiths AM, Alemayehu E, Sherman P. Clinical features of gastroduodenal Crohn's disease in adolescents. J Pediatr Gastroenterol Nutr 1989; 8 (02) 166-171
    CrossrefPubMedGoogle Scholar
  • 73 Fielding JF, Toye DK, Beton DC, Cooke WT. Crohn's disease of the stomach and duodenum. Gut 1970; 11 (12) 1001-1006
    CrossrefPubMedGoogle Scholar
  • 74 Miehsler W, Püspök A, Oberhuber T, Vogelsang H. Impact of different therapeutic regimens on the outcome of patients with Crohn's disease of the upper gastrointestinal tract. Inflamm Bowel Dis 2001; 7 (02) 99-105
    CrossrefPubMedGoogle Scholar
  • 75 Grübel P, Choi Y, Schneider D, Knox TA, Cave DR. Severe isolated Crohn's-like disease of the gastroduodenal tract. Dig Dis Sci 2003; 48 (07) 1360-1365
    CrossrefPubMedGoogle Scholar
  • 76 Firth MG, Prather CM. Unusual gastric Crohn's disease treated with infliximab: a case report. Am J Gastroenterol 2002; 97 (09) 190
    CrossrefPubMedGoogle Scholar
  • 77 Kawachiya T, Hara J, Hirata N, Mashimo M, Arakawa T. Successful treatment of duodenal Crohn disease with infliximab: report of 3 cases [in Japanese]. Nippon Shokakibyo Gakkai Zasshi 2010; 107 (12) 1933-1940
    PubMedGoogle Scholar
  • 78 Murthy UK. Repeated hydrostatic balloon dilation in obstructive gastroduodenal Crohn's disease. Gastrointest Endosc 1991; 37 (04) 484-485
    CrossrefPubMedGoogle Scholar
  • 79 Matsui T, Hatakeyama S, Ikeda K, Yao T, Takenaka K, Sakurai T. Long-term outcome of endoscopic balloon dilation in obstructive gastroduodenal Crohn's disease. Endoscopy 1997; 29 (07) 640-645
    Article in Thieme ConnectPubMedGoogle Scholar
  • 80 Matsuhashi N, Nakajima A, Suzuki A, Akanuma M, Yazaki Y, Takazoe M. Nonsurgical strictureplasty for intestinal strictures in Crohn's disease: preliminary report of two cases. Gastrointest Endosc 1997; 45 (02) 176-178
    CrossrefPubMedGoogle Scholar
  • 81 Rana SS, Bhasin DK, Chandail VS. , et al. Endoscopic balloon dilatation without fluoroscopy for treating gastric outlet obstruction because of benign etiologies. Surg Endosc 2011; 25 (05) 1579-1584
    CrossrefPubMedGoogle Scholar
  • 82 Sanderson IR, Udeen S, Davies PS, Savage MO, Walker-Smith JA. Remission induced by an elemental diet in small bowel Crohn's disease. Arch Dis Child 1987; 62 (02) 123-127
    CrossrefPubMedGoogle Scholar
  • 83 Buchman AL. Side effects of corticosteroid therapy. J Clin Gastroenterol 2001; 33 (04) 289-294
    CrossrefPubMedGoogle Scholar
  • 84 Wall CL, Day AS, Gearry RB. Use of exclusive enteral nutrition in adults with Crohn's disease: a review. World J Gastroenterol 2013; 19 (43) 7652-7660
    CrossrefPubMedGoogle Scholar
  • 85 Zachos M, Tondeur M, Griffiths AM. Enteral nutritional therapy for induction of remission in Crohn's disease. Cochrane Database Syst Rev 2007; (01) CD000542
    PubMedGoogle Scholar
  • 86 Worsey MJ, Hull T, Ryland L, Fazio V. Strictureplasty is an effective option in the operative management of duodenal Crohn's disease. Dis Colon Rectum 1999; 42 (05) 596-600
    CrossrefPubMedGoogle Scholar
  • 87 Salky B. Severe gastroduodenal Crohn's disease: surgical treatment. Inflamm Bowel Dis 2003; 9 (02) 129-130 , discussion 131
    CrossrefPubMedGoogle Scholar
  • 88 Tonelli F, Alemanno G, Bellucci F, Focardi A, Sturiale A, Giudici F. Symptomatic duodenal Crohn's disease: is strictureplasty the right choice?. J Crohn's Colitis 2013; 7 (10) 791-796
    PubMedGoogle Scholar
  • 89 Campbell L, Ambe R, Weaver J, Marcus SM, Cagir B. Comparison of conventional and nonconventional strictureplasties in Crohn's disease: a systematic review and meta-analysis. Dis Colon Rectum 2012; 55 (06) 714-726
    CrossrefPubMedGoogle Scholar
  • 90 Sampietro GM, Cristaldi M, Maconi G. , et al. A prospective, longitudinal study of nonconventional strictureplasty in Crohn's disease. J Am Coll Surg 2004; 199 (01) 8-20 , discussion 20–22
    CrossrefPubMedGoogle Scholar
  • 91 Navaneethan U, Liu X, Bennett AE, Walsh RM, Venkatesh PGK, Shen B. IgG4-associated ampullitis and cholangiopathy in Crohn's disease. J Crohn's Colitis 2011; 5 (05) 451-456
    PubMedGoogle Scholar
  • 92 Rivas JM, Erim T, Berho ME, Petras RE, Castro FJ. Crohn's disease of the common bile duct and ampulla causing obstructive jaundice and acute pancreatitis. Am J Gastroenterol 2009; 104 (04) 1053-1055
    CrossrefPubMedGoogle Scholar
  • 93 Yung K, Oviedo J, Farraye FA, Becker JM, Andrews Jr CWJ, Lichtenstein D. Ampullary stenosis with biliary obstruction in duodenal Crohn's disease: a case report and review of the literature. Dig Dis Sci 2005; 50 (06) 1118-1121
    CrossrefPubMedGoogle Scholar
  • 94 Racz JM, Davies W. Severe stricturing Crohn's disease of the duodenum: a case report and review of surgical options. Int J Surg Case Rep 2012; 3 (07) 242-245
    CrossrefPubMedGoogle Scholar
  • 95 Goswitz JT, Miller HP, Jacobi MA. Whipple resection for granulomatous enteritis of duodenum. Wis Med J 1971; 70 (09) 197-199
    PubMedGoogle Scholar
  • 96 Xingjun G, Feng Z, Min W, Renyi Q. Laparoscopic pancreaticoduodenectomy for the management of localized Crohn's disease of the duodenum. Indian J Surg 2016; 78 (04) 331-333
    CrossrefPubMedGoogle Scholar
  • 97 Franklin RH, Taylor S. Nonspecific granulomatous (regional) esophagitis. J Thorac Surg 1950; 19 (02) 292-297
    PubMedGoogle Scholar
  • 98 De Felice KM, Katzka DA, Raffals LE. Crohn's disease of the esophagus: clinical features and treatment outcomes in the Biologic Era. Inflamm Bowel Dis 2015; 21 (09) 2106-2113
    CrossrefPubMedGoogle Scholar
  • 99 Mashako MN, Cezard JP, Navarro J. , et al. Crohn's disease lesions in the upper gastrointestinal tract: correlation between clinical, radiological, endoscopic, and histological features in adolescents and children. J Pediatr Gastroenterol Nutr 1989; 8 (04) 442-446
    CrossrefPubMedGoogle Scholar
  • 100 Ramaswamy K, Jacobson K, Jevon G, Israel D. Esophageal Crohn disease in children: a clinical spectrum. J Pediatr Gastroenterol Nutr 2003; 36 (04) 454-458
    CrossrefPubMedGoogle Scholar
  • 101 Ruuska T, Vaajalahti P, Arajärvi P, Mäki M. Prospective evaluation of upper gastrointestinal mucosal lesions in children with ulcerative colitis and Crohn's disease. J Pediatr Gastroenterol Nutr 1994; 19 (02) 181-186
    CrossrefPubMedGoogle Scholar
  • 102 Decker GA, Loftus Jr EV, Pasha TM, Tremaine WJ, Sandborn WJ. Crohn's disease of the esophagus: clinical features and outcomes. Inflamm Bowel Dis 2001; 7 (02) 113-119
    CrossrefPubMedGoogle Scholar
  • 103 Rudolph I, Goldstein F, DiMarino Jr AJ. Crohn's disease of the esophagus: Three cases and a literature review. Can J Gastroenterol 2001; 15 (02) 117-122
    CrossrefPubMedGoogle Scholar
  • 104 D'Haens G, Rutgeerts P, Geboes K, Vantrappen G. The natural history of esophageal Crohn's disease: three patterns of evolution. Gastrointest Endosc 1994; 40 (03) 296-300
    CrossrefPubMedGoogle Scholar
  • 105 Zezos P, Kouklakis G, Oikonomou A, Pitiakoudis M, Simopoulos C. Esophageal Crohn's disease treated “topically” with swallowed aerosolized budesonide. Case Rep Med 2010; 2010 (04) 1-4
    PubMedGoogle Scholar
  • 106 Bonavina L, Bettineschi F, Cecchetto A, Pomerri F. Crohn's disease of the esophagus. Dysphagia 1989; 4 (03) 176-179
    CrossrefPubMedGoogle Scholar
  • 107 Hanai H, Honda S, Sugimoto K. , et al. Endoscopic therapy for multiple mucosal bridges in the esophagus of a patient with Crohn's disease. Gastrointest Endosc 1999; 50 (05) 715-717
    CrossrefPubMedGoogle Scholar
  • 108 Mathis G, Sutterlütti G, Dirschmid K, Feuerstein M, Zimmermann G. Crohn's disease of the esophagus: dilation of stricture and fibrin sealing of fistulas. Endoscopy 1994; 26 (05) 508-508
    Article in Thieme ConnectPubMedGoogle Scholar
  • 109 Thomas TS, Berto E, Scribano ML, Middleton SJ, Hunter JO. Treatment of esophageal Crohn's disease by enteral feeding via percutaneous endoscopic gastrostomy. JPEN J Parenter Enteral Nutr 2000; 24 (03) 176-179
    CrossrefPubMedGoogle Scholar
  • 110 Wespi SP, Frei R, Sulz MC. A very rare cause of a relapsing para-oesophageal abscess. Case Rep Gastroenterol 2016; 10 (01) 132-138
    CrossrefPubMedGoogle Scholar
  • 111 Wang W, Ni Y, Ke C, Cheng Q, Lu Q, Li X. Isolated Crohn's disease of the esophagus with esophago-mediastinal fistula formation. World J Surg Oncol 2012; 10 (01) 208-1
    CrossrefPubMedGoogle Scholar
  • 112 Gyde SN, Prior P, Macartney JC, Thompson H, Waterhouse JA, Allan RN. Malignancy in Crohn's disease. Gut 1980; 21 (12) 1024-1029
    CrossrefPubMedGoogle Scholar
  • 113 Rholl JC, Yavorski RT, Cheney CP, Wong RK. Esophagogastric fistula: a complication of Crohn's disease--case report and review of the literature. Am J Gastroenterol 1998; 93 (08) 1381-1383
    CrossrefPubMedGoogle Scholar