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. 1977 Feb;18(2):115–120. doi: 10.1136/gut.18.2.115

Crohn's disease of the duodenum.

F W Nugent, M Richmond, S K Park
PMCID: PMC1411288  PMID: 856671

Abstract

Crohn's disease of the duodenum is uncommon, occurring in approximately 2% of patients with Crohn's disease. Approximately 165 cases have been reported in small series in the literature. Our report includes 36 patients, most of whom had symptoms of duodenal disease coincident with or after obvious disease elsewhere in the gastrointestinal tract, although occasionally duodenal disease developed first and rarely disease was confined to the duodenum. Upper abdominal pain and symptoms of gastroduodenal obstruction are the commonest patterns of presentation. Significant weight loss is common, and occasionally major upper gastrointestinal bleeding occurs. The commonest pattern of involvement was contiguous disease of the proximal duodenum and distal stomach. Endoscopically, diffuse granularity, nodularity, and ulceration are seen accompanied by lack of distensibility of the involved area. Granulomas are rarely found in endoscopic biopsies. A bypass procedure was carried out on 18 patients, 15 of whom continue to be free of symptoms with an average follow-up of 6-6 years. When symptoms of obstruction dictate, operative bypass is accompanied by favourable long-term results in the large majority of patients.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bagby R. J., Rogers J. V., Jr, Hobbs C. Crohn's disease of the esophagus, stomach and duodenum: a review with emphasis on the radiographic findings. South Med J. 1972 May;65(5):515–523. doi: 10.1097/00007611-197205000-00001. [DOI] [PubMed] [Google Scholar]
  2. Bishop R. P., Brewster A. C., Antonioli D. A. Crohn's disease of the mouth. Gastroenterology. 1972 Feb;62(2):302–306. [PubMed] [Google Scholar]
  3. Cohen W. N. Gastric involvement in Crohn's disease. Am J Roentgenol Radium Ther Nucl Med. 1967 Oct;101(2):425–430. doi: 10.2214/ajr.101.2.425. [DOI] [PubMed] [Google Scholar]
  4. Danzi J. T., Farmer R. G., Sullivan B. H., Jr, Rankin G. B. Endoscopic features of gastroduodenal Crohn's disease. Gastroenterology. 1976 Jan;70(1):9–13. [PubMed] [Google Scholar]
  5. Edwards A. M., Michalyshyn B., Sherbaniuk R. W., Costopoulos L. B. Regional enteritis of the duodenum: a review and report of five cases. Can Med Assoc J. 1965 Dec 18;93(25):1283–1295. [PMC free article] [PubMed] [Google Scholar]
  6. Farmer R. G., Hawk W. A., Turnbull R. B., Jr Crohn's disease of the duodenum (transmural duodenitis): clinical manifestations. Report of 11 cases. Am J Dig Dis. 1972 Mar;17(3):191–198. doi: 10.1007/BF02232289. [DOI] [PubMed] [Google Scholar]
  7. Fedotin M. S., Grimmett G. M., Shelburne J. Crohn's disease of the mouth. Am J Dig Dis. 1974 Apr;19(4):385–388. doi: 10.1007/BF01072531. [DOI] [PubMed] [Google Scholar]
  8. Fielding J. F., Toye D. K., Beton D. C., Cooke W. T. Crohn's disease of the stomach and duodenum. Gut. 1970 Dec;11(12):1001–1006. doi: 10.1136/gut.11.12.1001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Haggitt R. C., Meissner W. A. Crohn's disease of the upper gastrointestinal tract. Am J Clin Pathol. 1973 May;59(5):613–622. doi: 10.1093/ajcp/59.5.613. [DOI] [PubMed] [Google Scholar]
  10. Hermos J. A., Cooper H. L., Kramer P., Trier J. S. Histological diagnosis by peroral biopsy of Crohn's disease of the proximal intestine. Gastroenterology. 1970 Dec;59(6):868–873. [PubMed] [Google Scholar]
  11. Jones G. W., Jr, Dooley M. R., Schoenfield L. J. Regional enteritis with involvement of the duodenum. Gastroenterology. 1966 Dec;51(6):1018–1022. [PubMed] [Google Scholar]
  12. Kim U. S., Zimmerman M. J., Weiss M. Massive upper gastrointestinal hemorrhage associated with Crohn's disease of the stomach and duodenum. A case report. Am J Gastroenterol. 1973 Mar;59(3):244–249. [PubMed] [Google Scholar]
  13. Legge D. A., Hoffman H. N., 2nd, Carlson H. C. Pancreatitis as a complication of regional enteritis of the duodenum. Gastroenterology. 1971 Dec;61(6):834–837. [PubMed] [Google Scholar]
  14. Nelson S. W. Some interesting and unusual manivestations of Crohn's disease ("regional enteritis") of the stomach, duodenum and small intestine. Am J Roentgenol Radium Ther Nucl Med. 1969 Sep;107(1):86–101. doi: 10.2214/ajr.107.1.86. [DOI] [PubMed] [Google Scholar]
  15. Nugent F. W. Crohn's colitis comes of age. Am J Gastroenterol. 1975 Jun;63(6):471–475. [PubMed] [Google Scholar]
  16. Paget E. T., Owens M. P., Peniston W. O., Mathewson C., Jr Massive upper gastrointestinal tract hemorrhage. A manifestation of regional enteritis of the duodenum. Arch Surg. 1972 Apr;104(4):397–400. doi: 10.1001/archsurg.1972.04180040011002. [DOI] [PubMed] [Google Scholar]
  17. Roberts S. M., Hamilton W. W. Regional enteritis of the duodenum. Radiology. 1966 May;86(5):881–885. doi: 10.1148/86.5.881. [DOI] [PubMed] [Google Scholar]
  18. Roseman D. M. Crohn's disease of the stomach and duodenum. Report of a case. Gastrointest Endosc. 1972 Nov;19(2):83–84. doi: 10.1016/s0016-5107(72)73962-0. [DOI] [PubMed] [Google Scholar]
  19. Sanders M. G., Schimmel E. M. The relationship between granulomatous bowel disease and duodenal ulcer. Am J Dig Dis. 1972 Dec;17(12):1100–1108. doi: 10.1007/BF02232312. [DOI] [PubMed] [Google Scholar]
  20. Silva J. R., Thomas J. M. Isolated regional enteritis of the duodenum. Am J Gastroenterol. 1972 Apr;57(4):349–352. [PubMed] [Google Scholar]
  21. Thompson W. M., Cockrill H., Jr, Rice R. P. Regional enteritis of the duodenum. Am J Roentgenol Radium Ther Nucl Med. 1975 Feb;123(2):252–262. doi: 10.2214/ajr.123.2.252. [DOI] [PubMed] [Google Scholar]
  22. VAN PATTER W. N., BARGEN J. A., DOCKERTY M. B., FELDMAN W. H., MAYO C. W., WAUGH J. M. Regional enteritis. Gastroenterology. 1954 Mar;26(3):347–450. [PubMed] [Google Scholar]
  23. Wise L., Kyriakos M., McCown A., Ballinger W. F. Crohn's disease of the duodenum. A report and analysis of eleven new cases. Am J Surg. 1971 Feb;121(2):184–194. doi: 10.1016/0002-9610(71)90097-3. [DOI] [PubMed] [Google Scholar]

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