Gastroduodenal and Ileocecal Crohn's Disease: A Report of an Operated Case due to Pyloric Stenosis.

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A 34-year-old man was admitted to our institution due to epigastralgia nausea and vomiting. Initially, H<SUB>2</SUB> receptor blocker and omeprazol were administered, which produced no effective improvement. Upper GI series and endoscopic examination revealed pyloric stenosis and ultrasonography revealed polyps of gall bladder. At the operation, ileocecal thickening and stenosis, mesenteric thickening, and swelling of mesenteric lymphnodes were observed, in addition to the gastroduodenal inflammation. These findings strongly suggested that the inflammation was due to Crohn's disease. Distal gastrectomy, ileocecal resection, and cholecystectomy were done, and reconstruction by Billroth-II method and ileocolonic anastomosis were performed. The resected specimen showed longitudinal ulceration in the ileum and cobblestone appearance in the duodenum. Histopathological examination disclosed non-caseating epithelioid granulomas scattered through the bowel wall. Two years after the operation, he is in remission and symptom-free Upper GI endoscopy and Ba enema revealed no recurrence of lesion or stomal ulcer.
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