Features of upper gastrointestinal involvement during the onset of Crohn’s disease

Abstract

Crohn’s disease (CD) is a multifactorial inflammatory disease in which any part of the gastrointestinal tract can be affected, however, it usually affects the ileum and/or colon. In order to assess the prognosis of the patient and the selection of an appropriate therapy regimen, it is necessary to accurately assess the factors affecting negative results, including the disease phenotype. Recently, with the introduction of mandatory endoscopic examination of the upper gastrointestinal tract (UGI) with suspected Crohn’s disease, diagnosis of organ lesions of this localization has become more common and described in the literature. Most of the clinical manifestations of esophageal, gastric or duodenal lesions are nonspecific and require morphological verification of the diagnosis, since they can occur under the guise of ordinary gastritis or duodenitis. In addition, histological findings such as marked focal erythematous gastropathy and non-vascular granulomas may be suggestive of CD. The association between upper UGI involvement and poor prognosis in Crohn’s disease remains controversial. Currently, there are no criteria for assessing the severity of the lesion and understanding the degree of participation of the upper gastrointestinal tract in CD for the long-term prognosis of the disease. This article presents the children’s own examination data and a clinical case of gastric and duodenal involvement at the onset of Crohn’s disease.