2018 Volume 60 Issue 12 Pages 2505-2511
We present two patients with Crohn’s disease. The first patient was a 38-year-old woman with a history of gastric ulcers who tested negative for Helicobacter pylori IgG and who was referred to our hospital for further examinations. Upper gastrointestinal endoscopy revealed multiple scars with small granular mucosae in the gastric body and fornix, and pathological examination of biopsied specimens from the multiple scars revealed the presence of granulomas. Total colonoscopy revealed aphthous ulcerations, and biopsied specimens from the aphthous ulcerations revealed noncaseating epithelioid cell granulomas. The patient was diagnosed with Crohn’s disease. The second patient was a 30-year-old man with a history of duodenal ulcers who visited our hospital with complaints of epigastralgia. He previously underwent successful treatment for H. pylori eradication, and he tested negative for H. pylori IgG. Upper endoscopy revealed an ulcer in the duodenum and multiple erosions in the gastric antrum. Because of his past history of anal fistula, we suspected Crohn’s disease. Colonoscopy revealed erosions in the terminal ileum, ulcers on Bauhin’s valve, and aphthous ulcerations in the sigmoid colon. Noncaseating epithelioid cell granulomas were detected in each biopsied specimen, and the patient was diagnosed with Crohn’s disease.
Crohn’s disease should be considered when peptic ulcers are refractory to treatment, H. pylori infection is negative, and when there is no history of using nonsteroidal anti-inflammatory drugs.
