Crohn's disease of the esophagus

Bonavina, Luigi; Bettineschi, Fulvio; Cecchetto, Attilio; Pomerri, Fabio

doi:10.1007/bf02408043

Cited by 8 publications

(6 citation statements)

References 14 publications

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“…3 Often, the diagnosis has been made postoperatively after the onset of severe complications requiring emergency surgery for free perforations or fistulae. 8,9 Consistently with these reports, in our patient with a history of heartburn the diagnosis was made on the specimen of the resected bowel after the third surgical procedure. This occurred several months after the duodenal and esophageal perforation, that were likely due to CD although histology was not available.…”

Section: Discussionsupporting

confidence: 80%

“…The diagnosis of upper gastrointestinal CD requires a high degree of suspicion due to both the non‐specificity of symptoms such as heartburn, dysphagia, and dyspepsia, and the non‐specificity of radiological and endoscopic findings including mucosal erythema, erosions and ulcers 3 . Often, the diagnosis has been made postoperatively after the onset of severe complications requiring emergency surgery for free perforations or fistulae 8,9 . Consistently with these reports, in our patient with a history of heartburn the diagnosis was made on the specimen of the resected bowel after the third surgical procedure.…”

Section: Discussionsupporting

confidence: 73%

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Heartburn and multiple-site foregut perforations as primary manifestation of Crohn’s disease

Bona

Incarbone

Chella

et al. 2005

Diseases of the Esophagus

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Crohn's disease may affect any segment of the digestive tract, more commonly the distal ileum, colon and/or perianal region. There is an increasing number of reports dealing with foregut Crohn's disease. We present the case of a patient with a history of heartburn and multiple spontaneous perforations of the esophagus, duodenum and jejunum as a primary manifestation of Crohn's disease who required emergency surgical and endoscopic procedures. Early detection of Crohn's disease may decrease the incidence of acute life-threatening complications provided that appropriate medical treatment is administered and a multidisciplinary approach is offered to these patients.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionsupporting

confidence: 73%

Heartburn and multiple-site foregut perforations as primary manifestation of Crohn’s disease

Bona

Incarbone

Chella

et al. 2005

Diseases of the Esophagus

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“…3 For stenotic lesions, advanced endoscopy with bougie or balloon dilatation has been effective and can delay or obviate the need for surgical intervention. 48,106 Stenotic lesions can also be managed with electrosurgical division under direct endoscopy for symptom relief. 48,107 Mathis et al described an esophageal CD stricture dilatation with concomitant fibrin sealant to manage an esophago-bronchial fistula with stricture for over 18 months.…”

Section: Surgical Treatment Of Esophageal Crohn's Diseasementioning

confidence: 99%

Crohn's Disease of the Esophagus, Duodenum, and Stomach

Schwartzberg

Brandstetter

Grucela

2019

Clinics in Colon and Rectal Surgery

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Upper gastrointestinal Crohn's is an under-reported, under-recognized phenotype of Crohn's disease. Routine screening in the pediatric population has shown a higher prevalence compared with adults; however, most adult patients remain asymptomatic with respect to upper gastrointestinal Crohn's disease. For the patients who are symptomatic, medical treatment is the first line of management, except for cases of obstruction, perforation, or bleeding. Though most patients respond to medical therapy, mainly steroids, with the addition of immunomodulators and more recently biologics agents, surgical intervention is usually required only for obstructing gastroduodenal disease secondary to strictures. Strictureplasty and bypass are safe operations with comparable morbidity, although bypass has higher rates of dumping syndrome and marginal ulceration in the long term. Rare cases of gastroduodenal fistulous disease from active distal disease may involve the stomach or duodenum, and esophageal Crohn's disease can fistulize to surrounding structures in the mediastinum which may require the highly morbid esophagectomy.

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“…Endoscopic and surgical intervention is rarely required, but may be indicated for severe disease or on development of complications . Esophageal dilatation and stenting are effective for dysphagia secondary to fibrotic strictures in 80% of cases, although these procedures carry risks of perforation, stricture recurrence, pain, and stent migration .…”

Section: Esophageal Diseasementioning

confidence: 99%

Oral and upper gastrointestinal Crohn's disease

Laube

Liu

Schifter

et al. 2018

J of Gastro and Hepatol

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Crohn's disease is a heterogeneous, inflammatory condition that can affect any location of the gastrointestinal tract. Proximal gastrointestinal involvement occurs in 0.5-16% of patients, and it is usually diagnosed after recognition of intestinal disease. Symptoms are often mild and nonspecific; however, upper gastrointestinal disease predicts a more severe Crohn's phenotype with a greater frequency of complications such as obstruction and perforation. Gastroscopy and biopsy is the most sensitive diagnostic investigation. There is a paucity of data examining the treatment of this condition. Management principles are similar to those for intestinal disease, commencing with topical therapy where appropriate, progressing to systemic therapy such as glucocorticoids, 5-aminosalicylic acid, immunomodulators, and biologics. Acid suppression therapy has symptomatic but no anti-inflammatory benefit for gastroduodenal and esophageal involvement. Surgical intervention with bypass, strictureplasty, or less frequently, endoscopic balloon dilation may be required for complications or failed medical therapy.

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Crohn's disease of the esophagus

Cited by 8 publications

References 14 publications

Heartburn and multiple-site foregut perforations as primary manifestation of Crohn’s disease

Heartburn and multiple-site foregut perforations as primary manifestation of Crohn’s disease

Crohn's Disease of the Esophagus, Duodenum, and Stomach

Oral and upper gastrointestinal Crohn's disease

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