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Diagnostic Challenges of Upper Gastrointestinal Tract Crohn's Disease.

作者信息

Beladev Sruthi, Joseph Krupa A, Madathiparambu Nikhil Charles

机构信息

Acute Medicine, Queen Elizabeth The Queen Mother Hospital, Margate, GBR.

出版信息

Cureus. 2025 Apr 14;17(4):e82221. doi: 10.7759/cureus.82221. eCollection 2025 Apr.


DOI:10.7759/cureus.82221
PMID:40376323
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12079158/
Abstract

Crohn's disease (CD) is a chronic inflammatory disorder that commonly affects the distal small bowel and proximal large bowel. However, it can involve any part of the gastrointestinal tract (GIT), including the upper GIT. However, upper GIT involvement is often overlooked due to the limited use of upper gastrointestinal (UGI) endoscopy and biopsy for diagnosis. We present a case of a 30-year-old male with an 11-year history of symptomatic CD. Despite multiple normal findings on various endoscopic and imaging evaluations, his symptoms persisted, leading to numerous treatment modifications from Pentasa foam enema to various biologics. Despite this, fecal calprotectin remained elevated. A critical diagnosis was made via video capsule endoscopy, revealing duodenitis and aphthous ulcers, and subsequent esophagogastroduodenoscopy (OGD) with histology confirming focal inflammation consistent with upper GIT CD of the stomach and duodenum. Despite aggressive treatment, the patient's symptoms persisted, necessitating comprehensive nutritional management. This case underscores the diagnostic challenges of upper GIT CD and highlights the importance of thorough endoscopic and histological evaluations for accurate diagnosis and effective management. Additionally, it underscores the usefulness of fecal calprotectin as an indication of inflammation and the relevance of nutritional management in controlling symptoms of upper GIT CD.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e4f/12079158/26fb11a53ee9/cureus-0017-00000082221-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e4f/12079158/a7802f60d0cf/cureus-0017-00000082221-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e4f/12079158/979e14429a08/cureus-0017-00000082221-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e4f/12079158/e2bace46f9ac/cureus-0017-00000082221-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e4f/12079158/3d1a50365f0e/cureus-0017-00000082221-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e4f/12079158/df9df3fed6aa/cureus-0017-00000082221-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e4f/12079158/768aedfc5097/cureus-0017-00000082221-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e4f/12079158/26fb11a53ee9/cureus-0017-00000082221-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e4f/12079158/a7802f60d0cf/cureus-0017-00000082221-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e4f/12079158/979e14429a08/cureus-0017-00000082221-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e4f/12079158/e2bace46f9ac/cureus-0017-00000082221-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e4f/12079158/3d1a50365f0e/cureus-0017-00000082221-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e4f/12079158/df9df3fed6aa/cureus-0017-00000082221-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e4f/12079158/768aedfc5097/cureus-0017-00000082221-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e4f/12079158/26fb11a53ee9/cureus-0017-00000082221-i07.jpg

相似文献

[1]
Diagnostic Challenges of Upper Gastrointestinal Tract Crohn's Disease.

Cureus. 2025-4-14

[2]
Characteristics of Upper Gastrointestinal Tract Involvement in Korean Pediatric Crohn's Disease: A Multicenter Study.

Pediatr Gastroenterol Hepatol Nutr. 2017-12

[3]
Crohn's Disease Confined to the Esophagus, with No Involvement of the Small or Large Bowel.

Eur J Case Rep Intern Med. 2024-10-31

[4]
The endoscopic findings of the upper gastrointestinal tract in patients with Crohn's disease.

Clin J Gastroenterol. 2017-8

[5]
Upper Gastrointestinal Involvement in Crohn's Disease as an Independent Predictor of New-Onset Strictures: Insights from an Extensive Retrospective Cohort Analysis.

Dig Dis Sci. 2024-9

[6]
Upper Gastrointestinal Crohn's Disease: Literature Review and Case Presentation.

Case Rep Gastrointest Med. 2019-5-20

[7]
Upper gastrointestinal tract involvement in Crohn's disease: A case report.

Int J Surg Case Rep. 2021-4

[8]
[An uncommon case of proximal Crohn's disease].

Semergen. 2012

[9]
Crohn's disease of the upper gastrointestinal tract.

Neth J Med. 1997-2

[10]
Heterogeneity of definition of upper gastrointestinal tract in different guidelines of Crohn's disease: A scoping review.

United European Gastroenterol J. 2024-12

本文引用的文献

[1]
Diet and Nutrition in Inflammatory Bowel Disease: A Review of the Literature.

Crohns Colitis 360. 2023-12-9

[2]
Fecal Calprotectin Elevations Associated with Food Intolerance/Malabsorption Are Significantly Reduced with Targeted Diets.

Nutrients. 2023-2-27

[3]
Upper Gastrointestinal Manifestations of Crohn's Disease: Differential Diagnosis and Treatment of an Uncommon Presentation of Crohn's Disease.

Mil Med. 2021-12-11

[4]
Upper Gastrointestinal Tract Involvement in Inflammatory Bowel Diseases: Histologic Clues and Pitfalls.

Adv Anat Pathol. 2022-1-1

[5]
Upper gastrointestinal tract involvement in Crohn's disease: A case report.

Int J Surg Case Rep. 2021-4

[6]
Role of Diet in the Development and Management of Crohn's Disease.

Curr Gastroenterol Rep. 2020-3-17

[7]
Crohn's disease of esophagus, stomach and duodenum.

World J Gastrointest Pharmacol Ther. 2019-3-7

[8]
Fecal Calprotectin.

Adv Clin Chem. 2018-10-1

[9]
Oral and upper gastrointestinal Crohn's disease.

J Gastroenterol Hepatol. 2018-2

[10]
3rd European Evidence-based Consensus on the Diagnosis and Management of Crohn's Disease 2016: Part 1: Diagnosis and Medical Management.

J Crohns Colitis. 2016-9-22

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