Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0010346 (Crohn's disease)
 21,615 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Duodenal Crohn's disease has an estimated incidence of 1% to 2% among patients with Crohn's disease. We report 89 patients with duodenal Crohn's disease. Common symptoms were upper abdominal pain and symptoms of gastroduodenal obstruction. Contiguous disease of the gastric antrum and duodenum was present in 60% of patients. Endoscopic examination revealed abnormalities in 62 of 67 patients. Granulomas or granulomatous inflammation was found in 37 of 76 patients. Forty-nine patients treated medically were followed up for 2-25 yr (median 9.7 yr). Good to excellent results were obtained in 45 patients. Thirty-three patients required surgical intervention, usually for gastroduodenal obstruction. Reoperation was required in eight patients, seven of whom had had vagotomy with gastroenterostomy or subtotal gastrectomy. In two of these seven patients, marginal ulcers developed. Both patients had had gastroenterostomy and vagotomy. Our experience does not support the routine use of vagotomy when a bypass procedure is performed. Good to excellent results were achieved in 26 of the 30 surgically treated patients followed up for more than 1 yr (1-43 yr; median 11 yr). Measured in terms of need for surgical intervention, gastroduodenal disease generated considerably less morbidity than did distal Crohn's disease (p less than 0.001). Most patients achieved good to excellent results whether treated medically or surgically.
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PMID:Duodenal Crohn's disease: an analysis of 89 cases. 291 81

Duodenal Crohn's disease is a rare condition not frequently encountered by the general or colo-rectal surgeon. Manifestations of Crohn's disease may appear in the duodenum as result of primary involvement, or secondary to complications of more distal gastrointestinal disease. Symptoms of duodenal Crohn's are often non-specific, and diagnosis can be difficult. This paper presents a summary of the published literature on duodenal Crohn's disease, including a review of the surgical approaches to this uncommon problem.
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PMID:Duodenal Crohn's disease. 1179 53

Duodenal Crohn's disease is rare, and patients without obstruction are treated medically. We herein report one case whose duodenal Crohn's disease was successfully managed with low-speed elemental diet infusion through a nasogastric tube. A 28-year-old female developed acute duodenal Crohn's disease. Upper GI radiologic and endoscopic examinations showed a stricture in the duodenal bulb. Using the duodenal biopsy specimens, mucosal cytokine levels were measured; interleukin (IL)-1beta, IL-6, IL-8, and tumor necrosis factor-alpha levels were remarkably elevated. For initial 2 wk, powdered mesalazine was orally given but it was not effective. For the next 2 wk, she was treated with low-speed elemental diet therapy using a commercially available Elental(TM), which was infused continuously through a nasogastric tube using an infusion pump. The tip of the nasogastric tube was placed at an immediate oral side of the pylorus. The infusion speed was 10 mL/h (usual speed, 100 mL/h). After the 2-wk treatment, her symptoms were very much improved, and endoscopically, the duodenal stricture and inflammation improved. The duodenal mucosal cytokine levels remarkably decreased compared with those before the treatment. Although our experience was limited, low-speed elemental diet infusion through a nasogastric tube may be a useful treatment for acute duodenal Crohn's disease.
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PMID:Acute duodenal Crohn's disease successfully managed with low-speed elemental diet infusion via nasogastric tube: a case report. 1648 85