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Papers of the Week

2018 Dec

Gastroenterology Res



Crohn’s Disease Manifesting as a Duodenal Obstruction: An Unusual Case.


Shah J, Etienne D, Reddy M, Kothadia JP, Shahidullah A, Baqui AAAM
Gastroenterology Res. 2018 Dec; 11(6):436-440.
PMID: 30627269.


We describe a case of a 31-year-old man who presented with a 3-year history of worsening upper abdominal pain, nausea, and vomiting: symptoms that were resistant to medical treatment and unexplained despite a thorough diagnostic evaluation. Then, an upper gastrointestinal series with small bowel follow-through showed proximal duodenal dilation and distal decompression of the duodenum, suggestive of a partial duodenal obstruction. An abdominal computed tomography (CT) scan revealed a transition point in the distal duodenum. At surgery, a segmental resection of the distal duodenum with a duodenojejunal anastomosis was performed. Histopathologic examination of the specimen revealed Crohn's disease. Therefore, making the diagnosis of duodenal obstruction has significant clinical implications and, in the setting of Crohn's disease, is evidence of an underlying intestinal stricture, stenotic area, or adhesion.