Abstract
A 48-year-old woman was admitted to our hospital because of painful swallowing. Upper gastrointestinal endoscopic examination showed a undermining deep ulcer with an elevated margin in the middle esophagus. However the biopsy specimens taken from the lesion showed histologically no epitheloid cell granulomas. We treated the lesion as a esophageal ulcer with unknown etiology. The ulcer were improved by fast and intravenous drip only for 4 days.
About 3 months later, the patient was admitted to our hospital again for same symptom. Endoscopic examination revealed a same esophageal ulcer as the last time one. Since the 8th hospital day, bloody stool was seen. So we performed colonoscopy at 8 November 1997. Colonoscopy showed ulcers with bleeding. We diagnosed both esophageal lesion and colon ulcers are due to Crohn's disease. The patient was treated by total parenteral nutrition and prednisolone, resulting in an improvement of both lesions.
There have been only one report of Crohn's disease which preceded esophageal ulcer in Japan. Our case is the second case. This case was therefore reported and compared with other literature about Crohn's disease with esophageal lesion.
