Gastroduodenal Crohn's disease presenting as biliary colic

Area of Science:

• Gastroenterology
• Internal Medicine
• Pathology

Background:

• Crohn's disease (CD) is a chronic inflammatory bowel disease.
• Gastroduodenal involvement in CD is uncommon, especially without typical ileocolonic disease.
• Regional enteritis is a form of Crohn's disease.

Purpose of the Study:

• To report a rare case of Crohn's disease affecting the stomach and duodenum.
• To highlight the diagnostic challenges and endoscopic findings in gastroduodenal Crohn's disease.
• To emphasize the significance of endoscopic biopsy in diagnosing rare gastrointestinal conditions.

Main Methods:

• Case presentation of a 31-year-old physician with a history of regional enteritis.
• Diagnostic work-up included roentgenography, endoscopy, and biopsy.
• Assessment of treatment response to steroids.

Main Results:

• The patient presented with gallstone and biliary colic, later diagnosed with Crohn's disease of the stomach and duodenum.
• Roentgenographic, endoscopic, and biopsy findings were consistent with Crohn's disease.
• Steroid therapy effectively managed symptoms, confirming their link to Crohn's disease.
• This case represents the ninth endoscopy and second biopsy demonstrating noncaseating granuloma in the stomach for Crohn's disease.

Conclusions:

• Gastroduodenal Crohn's disease is a rare manifestation of the condition.
• Endoscopic evaluation and biopsy are crucial for diagnosing rare forms of Crohn's disease.
• This case underscores the importance of considering Crohn's disease in the differential diagnosis of upper gastrointestinal symptoms, even with a history of regional enteritis.