Korean J Gastrointest Endosc.  2003 Jul;27(1):1-9.

Crohn's Disease of the Upper Gastrointestinal Tract: Endoscopic and Histologic Characteristics and Prevalence of Helicobacter pylori Infection

• Joung YH
• Lee DG
• Kim HJ
• Kim YW
• Lee BO
• Han YS
• Dong SH
• Kim BH
• Chang YW
• Lee JI
• Chang R

Abstract

BACKGROUND/AIMS
It is well known that Crohn's disease (CD) can affect all gastrointestinal tract. However, there was no report that evaluated upper gastrointestinal CD in Korea. Therefore, we assessed the endoscopic and histological characteristics of gastrointestinal CD and the prevalence of Helicobacter pylori infection in Korea.
METHODS
We examined forty-six patients who were diagnosed as having CD in Kyung Hee University Hospital. We analyzed the endoscopic and histological characteristics by endoscopic examination with biopsy and the prevalence of H. pylori infection. We also investigated the immunohistochemical characteristics of the biopsy specimen and assessed the effects of medications on both histologic and bacteriologic status.
RESULTS
High proportion (69.6%) of CD patients showed upper gastrointestinal mucosal alterations. Erosive endoscopic alteration was the most common finding with major involvement in the antrum and duodenum. In H. pylori negative CD patients, granuloma and focal gastritis were found in 30.6% and 44.4% of cases, respectively. There were no significant correlations between histologic features and clinical characeteristics of CD.
CONCLUSIONS
We conclude that histologic demonstration of focal gastritis and/or granuloma on endoscopic biopsy specimens in oligosymptomatic patients, especially in H. pylori negative patients, might be considered as patients with possible CD.

Keyword

Crohn's disease; Helicobacter pylori

MeSH Terms

Biopsy
Crohn Disease*
Duodenum
Gastritis
Gastrointestinal Tract
Granuloma
Helicobacter pylori*
Helicobacter*
Humans
Korea
Prevalence*
Upper Gastrointestinal Tract*