[Diagnostic and therapeutic aspects of gastroduodenal Crohn disease]

The duodenum or the stomach were involved in 20 (11%) of 177 patients with Crohn's disease. Four patients had no symptoms in the upper gastrointestinal tract, in ten patients pains and gastric disorders recurred. Six patients had severe symptoms caused by stenosis of the stomach or duodenum. The endoscopical and histological findings correlated to the severity of the symptoms. Early pathological changes were identified only by gastroscopy. We have little experience of the medical treatment of Crohn's disease of the duodenum or the stomach. A bypass procedure (gastrojejunostomy combined wih proximal-gastric vagotomy (PGV)) is indicated in all cases of severe gastric or duodenal stenosis.