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Crohn's disease confined to the esophagus, with no involvement of the small or large bowel

Authors :
Karam Karam
Helena Fahmi
Simon Bchara
Jamil Mrad
Anwar Andrew Nader
Elias Fiani
Source :
European Journal of Case Reports in Internal Medicine (2024)
Publication Year :
2024
Publisher :
SMC MEDIA SRL, 2024.

Abstract

Crohn's disease (CD) is a transmural inflammatory process that can affect any segment of the gastrointestinal tract. CD has a predilection for the colon and the small bowel, specifically the terminal ileum. Esophageal involvement of CD is exceedingly rare and there is a paucity of data regarding the disease phenotypes, course, complications and treatment. We report a case of an 18-year-old male patient presenting for intermittent dysphagia and epigastric pain. Upper endoscopy revealed esophageal ulcers in the middle esophagus surrounded by normal esophageal mucosa. Biopsies were taken from the ulcerated lesions. Histology revealed granulomatous esophagitis. The stomach and duodenum were unremarkable. An ileo-colonoscopy was performed and showed unremarkable mucosa with normal biopsies. The patient was started on proton pump inhibitors and prednisolone as induction therapy with significant symptomatic improvement within 15 days of therapy. The patient was then started on azathioprine 150 mg once daily as maintenance therapy with complete resolution of symptoms. Esophageal CD is an overlooked entity. This article underscores the need to rule out CD when physicians are confronted by esophageal ulcers on upper endoscopy.

Details

Language :
English
ISSN :
22842594
Database :
Directory of Open Access Journals
Journal :
European Journal of Case Reports in Internal Medicine
Publication Type :
Academic Journal
Accession number :
edsdoj.54ce7a95f595435884384981769029c0
Document Type :
article
Full Text :
https://doi.org/10.12890/2024_004926