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Gastric Crohn's Disease: A Rare Cause of Intermittent Abdominal Pain and Vomiting
Xu-Ting Zhi, MD, Jian-Guo Hong, MD, Tao Li, MS, Dong Sun, MS, De-Xin Yu, MD, Zhi-Qiang Chen, MD, Tao Li, MD The American Journal of Medicine Volume 130, Issue 5, Pages e181-e185 (May 2017) DOI: /j.amjmed Copyright © 2017 Elsevier Inc. Terms and Conditions
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Figure 1 Upper gastrointestinal study with Gastrografin (Bracco Diagnostic Inc, Monroe Township, NJ) revealed irregularity of the distal antrum in the prepyloric region and marked narrowing of the pylorus, duodenal bulb, and postbulbar duodenum (arrow). The American Journal of Medicine , e181-e185DOI: ( /j.amjmed ) Copyright © 2017 Elsevier Inc. Terms and Conditions
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Figure 2 Diffuse cobblestone mucosal change was present throughout the body of the stomach, and a bamboo joint-like appearance (arrow) of the gastric body was detected on radiography. The American Journal of Medicine , e181-e185DOI: ( /j.amjmed ) Copyright © 2017 Elsevier Inc. Terms and Conditions
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Figure 3 The transaxial, coronal, and sagittal cross-sectional contrast-enhanced CT scan showed multiple projections with slight enhancement along the gastric walls (A-C, arrow), as well as slight enhancement and thickening of the pylorus (D-F, arrow). The American Journal of Medicine , e181-e185DOI: ( /j.amjmed ) Copyright © 2017 Elsevier Inc. Terms and Conditions
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Figure 4 Endoscopic ultrasound showed focal thickening of the gastric mucosal and submucosal layers with hypoechoic layer (A, arrow); endoscopic ultrasound demonstrated significant circumferential thickening of the pylorus without normal stratification of the walls (B, arrow). The American Journal of Medicine , e181-e185DOI: ( /j.amjmed ) Copyright © 2017 Elsevier Inc. Terms and Conditions
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Figure 5 Esophagogastroduodenoscopy examination revealed erythema (A, black arrow), longitudinal ulcers (A, white arrow), cobblestone-like lesions in the gastric body, and mucosal edema, erosion, and narrowing of the pyloric antrum (B, arrow); histopathologic examination of biopsies from the stomach demonstrated nonspecific acute and chronic inflammation with massive neutrophil and lymphocyte infiltration (C); ileocolonoscopy demonstrated areas of polypoid hyperplasia in the terminal ileum (D, arrow), whereas the colon and rectum were normal (E); histopathologic examination of biopsies from terminal ileum showed granuloma, superficial small ulcers, and chronic inflammatory cell infiltration (F). The American Journal of Medicine , e181-e185DOI: ( /j.amjmed ) Copyright © 2017 Elsevier Inc. Terms and Conditions
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