Abstract
Endoscopic examination of the stomach and duodenum was carried out in 4 cases (25 y. o. male, 20 y. o. female, 27 y. o. male & 22 y. o. female) consecutive of Crohn's disease which had already involved the small and/or large intestine. The characteristic endoscopic features are summarized as 1) patchy erythema (multi ple focal erythematous spots, about 3-4 mm in diameter), 2) aphthoid erosion, 3) elevated lesion with central depression, 4) solitary verrucous lesion and 5) radial linear erosion. In 12 of 48 biopsy specimens obtained directly from these lesions, sarcoid granulomas were histologically confirmed (25%). The histological detection rate of sarcoid granuloma in each lesion was 75% in patchy erythema, 50% in aphthoid erosion, 27% in elevated lesion with central depression and 20% in verrucous lesion and null in radial linear erosion, respectively. These lesions were all located in the antral area and considered as early gastric manifestation of the gastric involvement of Crohn's disease without producing any upper GI symptom clinically. These results suggest that the 4 gastric lesions except for the last one would be directly caused by the gastric involvement of Crohn's disease.Endoscopic detection and follow up of the “early” gastric lesion would be extremely significant for morphological understanding of the developmental process of the disease.
