Reduced production of digestive proteases and the efficacy of enteral and parenteral nutrition on inflammatory bowel disease

✍ Scribed by Xiaofa Qin

• Publisher: John Wiley and Sons
• Year: 2008
• Tongue: English
• Weight: 44 KB
• Volume: 14
• Category: Article
• ISSN: 1078-0998
• DOI: 10.1002/ibd.20366

✦ Synopsis

Correlation with CT showed circumferential mural thickening, most marked at C7-T2, measuring up to 1.5 cm. The distal esophagus was of normal caliber. Upper endoscopy was reattempted by the surgical unit in theater under general anesthetic. Successful passage and dilatation of the stricture was performed. Esophageal biopsies were taken, which showed ulcerated mucosa with nonspecific inflammatory changes. There was no granulomatous inflammation identified. There was no dysplasia or malignancy seen.

Distinguishing esophageal CD from its differentials, in particular reflux esophagitis, can be difficult, as a welldefined diagnostic criteria is yet to be established. Noncaseating granulomas occur in less than 25% of cases 4 ; thus, their presence is not required to make the diagnosis. Based on the clinical history, radiological, and endoscopic findings discussed for this patient, it was agreed among both medical and surgical specialist units that her CD was the underlying pathology for the upper esophageal stricture.

The severe proximal esophageal disease in this case report highlights the fact that the distribution of CD can and does involve any segment of the gastrointestinal tract, from the mouth to the anus.