A CASE OF CROHN'S DISEASE WITH DUODENAL INVOLVEMENT

Abstract

This case report describes a patient of Crohn's disease with duodenal involvement. A 25-year-old man was admitted to our hospital complaining of diarrhea and fever in May, 1983. He had been treated for small intestinal and colonic Crohn's disease since the first admission. At the first admission, endoscopic examination showed an ulcer scar in the duodenal bulb but granuloma was not found in the biopsied specimen obtained from the duodenal lesion. In January, 1984, endoscopic examination showed a duodenal ulcer and he was then admitted again for a pyloric stenosis in February, 1984. Endoscopic examination showed multiple elevated lesions in the duodenal bulb with annular stenosis. Surgical resection of the stenotic lesion of the duodenum was performed in May, 1984. The duodenal wall of the resected specimen was thick and histologically, granulomas were found. Therefore, this was diagnosed as duodenal involvement of Crohn's disease. In March, 1986, a stenotic change was observed in the colon but no duodenal stenosis recurred, regardless of occasional appearance of erosions in the remaining duodenum.