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Journals / Endoskopi Gastrointestinal / 2026 / Cilt: 25 Sayı: 2

Upper Gastrointestinal System Involvement of Crohn’s Disease: Single Center Experience

Crohn Hastalığının Üst Gastrointestinal Sistem Tutulumu: Tek Merkez Deneyimi

Muhammet Yener Akpınar(Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Gastroenteroloji Kliniği, Ankara, Türkiye)0000-0003-0903-4664
Yasemin Özderin Özin(Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Gastroenteroloji Kliniği, Ankara, Türkiye)0000-0002-8744-4936
Zeki Mesut Yalın Kılıç(Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Gastroenteroloji Kliniği, Ankara, Türkiye)0000-0001-7295-9227
İsmail Hakkı Kalkan(Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Gastroenteroloji Kliniği, Ankara, Türkiye)0000-0003-3871-9814
Mahmut Yüksel(Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Gastroenteroloji Kliniği, Ankara, Türkiye)0000-0002-4727-2834
Mustafa Kaplan(Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Gastroenteroloji Kliniği, Ankara, Türkiye)
İlyas Tenlik(Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Gastroenteroloji Kliniği, Ankara, Türkiye)0000-0001-9546-2918
Özlem Akdoğan(Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Gastroenteroloji Kliniği, Ankara, Türkiye)0000-0002-8656-4581
Ömer Öztürk(Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Gastroenteroloji Kliniği, Ankara, Türkiye)0000-0002-4545-7149
Ertuğrul Kayaçetin(Türkiye Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Gastroenteroloji Kliniği, Ankara, Türkiye)0000-0002-8822-3991
Pages
32–34
Publication Date
2017-08-29
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Early diagnosis and appropriate treatment are necessary to prevent complications.

📌 3 Key Takeaways

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Objective & Hypothesis:Background and Aim: The frequency of upper gastrointestinal system involvement in Crohn’s disease is 0.5%–4%.
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Key Findings & Data:Treatment and follow-up strategies of these patients differ from those of ileocolonic disease.
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Conclusion & Impact:Early diagnosis and appropriate treatment are necessary to prevent complications.
🔬Design:Araştırma Makalesi
📍Scope:Comprehensive Sample
⚙️Variables:Crohn Hastalığı · üst gastrointestinal sistem tutulumu · Crohn’s disease

Abstract

Background and Aim: The frequency of upper gastrointestinal system involvement in Crohn’s disease is 0.5%–4%. Treatment and follow-up strategies of these patients differ from those of ileocolonic disease. Here we present our patients who had Crohn’s disease with upper gastrointestinal system involvement. Materials and Methods: We retrospectively investigated our patients who had Crohn’s disease with upper gastrointestinal system involvement. Results: Upper gastrointestinal system involvement was detected in 10 patients. The median age of patients was 40.5 years (31-53 years); 6 patients were male and 4 patients were female. The median follow-up period after diagnosis was 29 (1-228) months. Four patients had isolated upper gastrointestinal system involvement, while 6 patients had ileocolonic disease. The frequency of organ involvement was 10% (1 patient) for the esophagus, 20% (2 patients) for the stomach, and 70% (7 patient) for the duodenum. Endoscopic appearances varies among patients; cobble stone appearances were detected in 2 patients, ulcers were detected in 7 patients and nodulariy were detected in 4 patients. Granulomas were detected histopathologically in 3 patients (30%). Conclusion: Complaints like epigastric pain, nausea and vomiting, and/or dysphagia must warrant clinicians to investigate the upper gastrointestinal system in Crohn’s disease. Early diagnosis and appropriate treatment are necessary to prevent complications.

Özet

Giriş ve Amaç: Crohn hastalığı için üst gastrointestinal sistem tutulumu sıklığı %0,5-4 arasında değişir. Bu hastaların tedavi ve takipleri ileokolonik hastalıktan farklılık gösterir. Biz bu çalışmada kliniğimizde Crohn hastalığının üst gastrointestinal sistemi etkilediği hastalarımızı sunduk. Gereç ve Yöntem: Hastanemiz Gastroenteroloji Kliniğinde takip edilen ve üst gastrointestinal sistem tutulumu olan Crohn hastaları çalışmaya alındı. Bulgular: On hastada üst gastrointestinal sistem tutulumu izlendi. Hastaların yaş ortancası 40,5 (31-53) olup 6 hasta (%60) erkek 4 hasta (%40) ise kadındı. Ortanca takip süresi 29 (1-228) ay olup hastaların 4 tanesinde (%40) izole üst gastrointestinal sistem tutulumu varken geri kalan 6 hastanın (%60) beraberinde ileal veya ileokolonik hastalığı vardı. Organ tutulumlarına bakıldığında 1 hastada (%10) özofagus, 2 hastada mide (%20) ve 7 hastada (%70) duodenum tutulumu izlendi. Endoskopik görünümler hastadan hastaya değişmekle beraber Crohn hastalığı için tipik sayılan kaldırım taşı görünümü 2 hastada, ülserler 7 hastada ve nodülarite ise 4 hastada endoskopik olarak tanımlandı. Biyopsilerde granülom 3 hastada izlendi (%30) Sonuç: Crohn hastalığı tanısı olan bir bireyde gelişen epigastrik ağrı, bulantı-kusma ve disfaji gibi şikayetler üst gastrointestinal sistem in endoskopik incelenmesini zorunlu hale getirmektedir. Erken tanı ve uygun tedavi gelişebilecek komplikasyonların önüne geçebilir.

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Cite This Article

Akpınar, M. Y., Özin, Y. Ö., Kılıç, Z. M. Y., Kalkan, İ. H., Yüksel, M., Kaplan, M., Tenlik, İ., Akdoğan, Ö., Öztürk, Ö., Kayaçetin, E. (2017). Upper Gastrointestinal System Involvement of Crohn’s Disease: Single Center Experience. Endoskopi Gastrointestinal, Cilt: 25 Sayı: 2, 32–34. https://doi.org/10.17940/endoskopi.337852

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References (2)

  1. Crohn BB, Ginzburg L, Oppenheimer GD. Regional ileitis. A pathologic and clinical entity. JAMA 1932;99:1323–9 2- Satsangi J, Silverberg MS; Vermeire S. The Montreal classification of inflammatory bowel disease: controversies, consensus and implications. Gut. 2006; 55 (6):749-53 3- Wagtmans MJ, van Hogezand RA, Griffioen G, et al. Crohn’s disease of the upper gastrointestinal tract. Neth J Med 1997;50(2):S2–7. 4- Ingle SB, Adgaonkar BD, Jamadar NP et al. Crohn’ disease with gastroduodenal involvement: Diagnostic approach. World J Clin Cases 2015,3:479-483 5- Van Assche G, Dignass A, Panes J et al. The second European evidence-based consensus on the diagnosis and management of Crohn’s disease: definition and diagnosis. J Crohn’s Colitis. 2010;4:7-27 6- Hisabe T, Hirai F, Matsui T et al. Evaluation of diagnostic criteria for Crohn’s disease in Japan. J Gastroenterol. 2014;49(1):93-9. 7- Fujiya M, Sakatani A, Dokoshi T. A Bamboo Joint-Like Appearance is a Characteristic Finding in the Upper Gastrointestinal Tract of Crohn's Disease Patients: A Case-Control Study. Medicine (Baltimore). 2015;94(37):e1500. 8- Diaz L, Hernandez-Oquet RE, Deshpande AR et al. Upper Gastrointestinal Involvement in Crohn’s Disease: Histopathologic and Endoscopic Findings. South Med J 2015;108(11):695-700. 9- Loftus EV Jr. Upper gastrointestinal tract Crohn’s disease. Clin Perspect Gastroenterol 2002;5:188-191 10- Van Hogezand RA, Witte AM, Veenendaal RA et al. Proximal Crohn’s disease. Review of the clinicopathologic features and therapy. Inflamm Bowel Dis 2001;7:328-337 11- Rutgeerts P, Onette E, Vantrappen G, et al. Crohn’s disease of the stomach and duodenum: a clinical study with emphasis on the value of endoscopy and endoscopic biopsies. Endoscopy 1980;12:288-94 12- Yamamoto T, Allan RN, Keighley MR. An audit of gastroduodenal Crohn disease; clinicopathologic features and management. Scand J Gastroenterol 1999;34:1019-1024. 13- Firth M, Prather C. Unusual gastric Crohn’s disease treated with infliximab–A case report. Am J Gastroenterol 2002;97:S190 14- Kim YL, Park YS, Park EK. Refractory duodenal Crohn's disease successfully treated with infliximab.Intest Res. 2014;12(1):66-9. 15- Shapiro M, Greenstein AJ, Byrn J. Surgical management and outcomes of patients with duodenal Crohn’s disease. J Am Coll Surg; 207(1):36-42
  2. Crohn BB, Ginzburg L, Oppenheimer GD. Regional ileitis. A pathologic and clinical entity. JAMA 1932;99:1323–9 2- Satsangi J, Silverberg MS; Vermeire S. The Montreal classification of inflammatory bowel disease: controversies, consensus and implications. Gut. 2006; 55 (6):749-53 3- Wagtmans MJ, van Hogezand RA, Griffioen G, et al. Crohn’s disease of the upper gastrointestinal tract. Neth J Med 1997;50(2):S2–7. 4- Ingle SB, Adgaonkar BD, Jamadar NP et al. Crohn’ disease with gastroduodenal involvement: Diagnostic approach. World J Clin Cases 2015,3:479-483 5- Van Assche G, Dignass A, Panes J et al. The second European evidence-based consensus on the diagnosis and management of Crohn’s disease: definition and diagnosis. J Crohn’s Colitis. 2010;4:7-27 6- Hisabe T, Hirai F, Matsui T et al. Evaluation of diagnostic criteria for Crohn’s disease in Japan. J Gastroenterol. 2014;49(1):93-9. 7- Fujiya M, Sakatani A, Dokoshi T. A Bamboo Joint-Like Appearance is a Characteristic Finding in the Upper Gastrointestinal Tract of Crohn's Disease Patients: A Case-Control Study. Medicine (Baltimore). 2015;94(37):e1500. 8- Diaz L, Hernandez-Oquet RE, Deshpande AR et al. Upper Gastrointestinal Involvement in Crohn’s Disease: Histopathologic and Endoscopic Findings. South Med J 2015;108(11):695-700. 9- Loftus EV Jr. Upper gastrointestinal tract Crohn’s disease. Clin Perspect Gastroenterol 2002;5:188-191 10- Van Hogezand RA, Witte AM, Veenendaal RA et al. Proximal Crohn’s disease. Review of the clinicopathologic features and therapy. Inflamm Bowel Dis 2001;7:328-337 11- Rutgeerts P, Onette E, Vantrappen G, et al. Crohn’s disease of the stomach and duodenum: a clinical study with emphasis on the value of endoscopy and endoscopic biopsies. Endoscopy 1980;12:288-94 12- Yamamoto T, Allan RN, Keighley MR. An audit of gastroduodenal Crohn disease; clinicopathologic features and management. Scand J Gastroenterol 1999;34:1019-1024. 13- Firth M, Prather C. Unusual gastric Crohn’s disease treated with infliximab–A case report. Am J Gastroenterol 2002;97:S190 14- Kim YL, Park YS, Park EK. Refractory duodenal Crohn's disease successfully treated with infliximab.Intest Res. 2014;12(1):66-9. 15- Shapiro M, Greenstein AJ, Byrn J. Surgical management and outcomes of patients with duodenal Crohn’s disease. J Am Coll Surg; 207(1):36-42