Callaghan James, Brown Sarah, Battcock Tim, Parry Sally, Snook Jonathon
Department of Gastroenterology, Poole Hospital, Poole, UK.
Department of Elderly Care, Poole Hospital, Poole, UK.
Frontline Gastroenterol. 2012 Jul;3(3):201-205. doi: 10.1136/flgastro-2012-100126. Epub 2012 May 1.
Peptic ulceration is a recognised feature of Crohn's disease, but the characteristics of this manifestation are rather poorly described. Furthermore, most reports in the literature relate to ulcer disease in cases of established Crohn's disease. The authors report a series of four cases in which the diagnosis of Crohn's disease was preceded by peptic ulceration. Potential confounding factors were as far as possible excluded, implying a true association. Characteristics of the ulcer disease included (1) a multifocal distribution, (2) negativity and (3) an unusually aggressive clinical course despite proton pump inhibitor therapy, necessitating endoscopic or surgical intervention in three cases. Crohn's-related peptic ulceration is a relatively common manifestation which may precede the diagnosis of Crohn's disease itself. Recognition of the underlying diagnosis may be hampered by non-specific histology, but is important in view of the aggressive course of the ulceration, which may respond to medical therapy for Crohn's disease.
消化性溃疡是克罗恩病的一个公认特征，但对这一表现的特点描述得相当少。此外，文献中的大多数报告都与已确诊的克罗恩病患者的溃疡病有关。作者报告了一系列4例病例，这些病例在诊断为克罗恩病之前就出现了消化性溃疡。尽可能排除了潜在的混杂因素，这意味着存在真正的关联。溃疡病的特点包括：（1）多灶性分布；（2）阴性；（3）尽管使用了质子泵抑制剂治疗，但临床病程异常侵袭性，3例患者需要进行内镜或手术干预。克罗恩病相关的消化性溃疡是一种相对常见的表现，可能先于克罗恩病本身的诊断出现。非特异性组织学可能会妨碍对潜在诊断的认识，但鉴于溃疡的侵袭性病程，认识到这一点很重要，因为针对克罗恩病的药物治疗可能对其有效。
