Esophageal Involvement with Crohn's Disease on Upper Gastrointestinal Endoscopy Tsutomu Hamada 1 , Kenji Kondo 1 , Masakazu Takazoe 1 , Satoshi Saito 1 , Tsuyoshi Abe 1 , Ai Suzaki 1 , Takaaki Kawaguchi 1 , Yumiko Hojo 1 , Shigehiro Kitamura 2 , Keiji Okuda 3 , Yasushi Tananka 3 , Kiyohito Unuma 3 1Department of Internal Medicine, Social Health Insurance Medical Center, Tokyo 2Department of Pathology, Social Health Insurance Medical Center, Tokyo 3Department of Radiology, Social Health Insurance Medical Center, Tokyo Keyword: Crohn病 , 食道病変 , 非乾酪性肉芽腫 , 薬物療法 pp.403-416
Published Date 2007/4/25
DOI https://doi.org/10.11477/mf.1403101016
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 In the period of ten years (1997~2006), we have carried out upper gastrointestinal endoscopy on 482 patients (337 men and 145 women, aged 15~74, mean, 34.1±10.8 years, 299 for symptoms and 183 for screening) with Crohn's disease. Esophageal involvement was recognized in 23 patients (4.8%), and although upper GI involvement was not recognized in 4 of there patients, 19 of them had complaints referable to upper GI. At the same time, gastro-duodenal involvement was observed in the stomach of 156 patients and duodenal involvement was found in 190 patients. Endoscopic findings of the esophageal lesions were cobblestone appearance in 2 patients, linear ulcers in 5 patients, aphthous and punched-out ulcers in 8 patients and small erosions in 8 patients. The formation of fistula involving the bronchus was revealed in one patient. Biopsy specimens were taken from the esophageal lesions of the 19 patients and noncaseating epithelioid cell granuloma, which is characteristic of Crohn's disease, was identified in only one patient (5.3%). Esophageal lesions of 13 patients were found more than 10 years after their onsets but 2 patients suffered the esophageal lesions as initial signs of Crohn's disease. The drugs such as mesalazine, PPI, infliximab and prednisolone were effective for the esophageal lesions and their symptoms.

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