Abstract
A 24-year-old male operated on for perianal abscess one year earlier was admitted to Meitetsu Hospital in April 1983, complaining of diarrhea, right lower abdominal pain and a palpable mass. Upper GI series showed a stenosis and multiple polypoid lesions of the duodenum. Barium enema revealed longitudinal ulcerations and a stenosis of the terminal ileum. A biopsy specimen obtained from an area near the ileocecal junction revealed non-caseating granuloma. From these findings, the patient was diagnosed as having Crohn's disease of the duodenum, ileum and colon. The patient responded well to prednisolone and was discharged in September 1983. However, six months later, he was re-admitted with a relapse of the right lower abdominal pain. After treatment with elemental diet (ED), his symptoms disappeared, and he was discharged in August 1984. Since then he has remained on per os ED therapy and has kept well. Six cases of gastroduodenal Crohn's disease previously reported in Japan, were treated surgically. We, however, suggest that patients with gastroduodenal Crohn's disease can be treated conservatively with careful follow-up.
