Crohns Disease of the Esophagus: Three Cases and a Literature ReviewReport as inadecuate

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Canadian Journal of Gastroenterology - Volume 15 2001, Issue 2, Pages 117-122

Mini-Review Division of Gastroenterology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA

Received 6 July 1999; Accepted 12 July 1999

Copyright © 2001 Hindawi Publishing Corporation. This open-access article is distributed under the terms of the Creative Commons Attribution Non-Commercial License CC BY-NC, which permits reuse, distribution and reproduction of the article, provided that the original work is properly cited and the reuse is restricted to noncommercial purposes.


Three cases of esophageal Crohn-s disease CD are described, each with dysphagia and-or odynophagia caused by esophageal ulceration. All three patients had associated ileocolitis. One patient followed for a prolonged period responded to treatment with sulfasalazine and prednisone. A computer search back to 1967 produced 72 additional cases of esophageal CD. Among these 75 patients total, who were, on average, 34 years old, esophageal disease was the presenting disease symptom in 41 patients 55%. The diagnosis was difficult in 13 patients, in whom no distal bowel disease was detected at the time of initial esophageal presentation. The most common presentation was dysphagia associated with aphthous or deeper ulcerations 52 patients. In 11 of these patients, oral aphthous ulcerations were also present. Esophageal stenosis or fistulas to surrounding structures were present in 27 patients and led to surgery in 17 patients. Most of the unfavourable outcomes were in this group of 27 patients with esophageal complications, including five deaths. Fourteen additional patients required surgery for CD of other areas. Responses of uncomplicated ulcerative disease of the esophagus tended to be favourable if the medical regimen included prednisone. Clinical patterns of esophageal CD were divided into three categories: ulcerative, stenosing and asymptomatic acute disease in children.

Author: Ivan Rudolph, Franz Goldstein, and Anthony J DiMarino



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