Rutgeerts P, Onette E, Vantrappen G, Geboes K, Broeckaert L, Talloen L
Endoscopy. 1980 Nov;12(6):288-94. doi: 10.1055/s-2007-1021762.
The aim of this study was to correlate endoscopic, radiological and pathological observations in 30 patients with Crohn's disease, with involvement of the stomach and/or duodenum. The incidence of gastroduodenal involvement in our patients with Crohn's disease is about 3%. 22 of the 30 patients had intrinsic lesions of the stomach and/or duodenum; in 8 patients the lesions seemed to be produced by involvement from contiguous diseased bowel. Radiological studies and endoscopy of the gastroduodenal region are complementary. Endoscopy allows better visualisation of mucosal defects. Other features, for example a diminished expansion and the presence of contiguity lesions, are better demonstrated by barium meal. The mucosal lesions found at endoscopy are heterogenous, but irregularly-shaped ulcers and erosions in a disrupted mucosal pattern are typical for gastroduodenal Crohn's disease. Pathological examination of endoscopic "forceps"-biopsies permitted a conclusive diagnosis based on the presence of granulomas, in 15/22 (68%) of the cases with intrinsic gastroduodenal disease. This observation indicates that simple forceps biopsy is a very useful diagnostic tool. Involvement of the first part of the duodenum in Crohn's disease was complicated by a biliary fistula in two patients.
本研究旨在关联30例胃和/或十二指肠受累的克罗恩病患者的内镜、放射学及病理学观察结果。在我们的克罗恩病患者中，胃十二指肠受累的发生率约为3%。30例患者中有22例存在胃和/或十二指肠的固有病变；8例患者的病变似乎是由相邻病变肠段的累及所致。胃十二指肠区域的放射学检查和内镜检查互为补充。内镜检查能更好地观察黏膜缺损情况。其他特征，如扩张受限和连续性病变的存在，通过钡餐检查能得到更好的显示。内镜检查发现的黏膜病变具有异质性，但不规则形状的溃疡和黏膜形态破坏处的糜烂是胃十二指肠克罗恩病的典型表现。对内镜“钳取”活检组织进行病理检查，在22例胃十二指肠固有疾病病例中的15例（68%），基于肉芽肿的存在做出了确诊。这一观察结果表明，单纯钳取活检是一种非常有用的诊断工具。两名患者的十二指肠第一部受累并发了胆瘘。
