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DOI: 10.1055/s-0029-1214498
© Georg Thieme Verlag KG Stuttgart · New York
Esophageal Crohn’s disease
J.-M. YangMD
Department of Gastroenterology
Zhejiang Provincial
People’s Hospital
Hangzhou 310014
China
Fax: +86-571-85131448
Email: jianminyang@hotmail.com
Publication History
Publication Date:
28 September 2009 (online)
Esophageal involvement in Crohn’s disease is uncommon event, especially solitary esophageal Crohn’s disease, with an incidence ranging from 0.3 % to 2 % [1] [2] [3]. We report a case of solitary esophageal Crohn’s disease.
A 46-year-old Chinese woman was admitted to hospital in April 2007, presenting with a history of continuous mouth ulcers, pain on swallowing, and chest pain; she had been unable to take solid food for 5 months. Gastroscopy revealed one huge ulcer in the esophagus, located 28 – 33 cm from the upper incisors and around two-thirds of the circumference, with its base of a cobblestone appearance ([Fig. 1 a]). Histological examination of biopsy specimens from the ulcer margin revealed chronic inflammation. Endoscopic ultrasonography showed a heterogeneous hypoechoic lesion with a thickened wall around 9 – 15 mm in the esophagus; all five layers of the esophageal wall were disordered, the adventitia was interrupted, and mediastinal lymphadenitis was present ([Fig. 1 b]). Colonoscopy and barium studies of the small intestine as well as capsule endoscopy revealed no abnormality. At first, antituberculosis treatment was applied as a diagnostic therapy, but 1 month later the esophageal ulcer expanded to the full circumference and became deeper ([Fig. 1 c]). Then esophageal Crohn’s disease was considered. Treatment started with prednisone (40 mg p. o., q. d.) and olsalazine (1000 mg p. o., t. i. d.). The prednisone was gradually withdrawn over 3 months and the olsalazine (500 mg t. i. d.) was maintained for 1 year. In the follow-up period, gastroscopy showed the ulcer disappearing gradually and the mucosal lesion being completely repaired piece by piece ([Fig. 1 d]).
Endoscopy_UCTN_Code_CCL_1AB_2AC_3AZ
#References
- 1 Naranio-Rodriguez A, Solorzano-Peck G, Lopez-Rubio F. et al . Isolated oesophageal involvement of Crohn’s disease. Eur J Gastroenterol Hepatol. 2003; 15 1123-1126
- 2 Heller T, James S P, Drachenberg C. et al . Treatment of severe esophageal Crohn’s disease with infliximab. Inflamm Bowel Dis. 1999; 5 279-282
- 3 Rudolph I, Goldstein F, DiMarino jr. A J. et al . Crohn’s disease of the esophagus: three cases and a literature review. Can J Gastroenterol. 2001; 15 117-122
J.-M. YangMD
Department of Gastroenterology
Zhejiang Provincial
People’s Hospital
Hangzhou 310014
China
Fax: +86-571-85131448
Email: jianminyang@hotmail.com
References
- 1 Naranio-Rodriguez A, Solorzano-Peck G, Lopez-Rubio F. et al . Isolated oesophageal involvement of Crohn’s disease. Eur J Gastroenterol Hepatol. 2003; 15 1123-1126
- 2 Heller T, James S P, Drachenberg C. et al . Treatment of severe esophageal Crohn’s disease with infliximab. Inflamm Bowel Dis. 1999; 5 279-282
- 3 Rudolph I, Goldstein F, DiMarino jr. A J. et al . Crohn’s disease of the esophagus: three cases and a literature review. Can J Gastroenterol. 2001; 15 117-122
J.-M. YangMD
Department of Gastroenterology
Zhejiang Provincial
People’s Hospital
Hangzhou 310014
China
Fax: +86-571-85131448
Email: jianminyang@hotmail.com