ESOPHAGOGASTRIC FISTULA - A COMPLICATION OF CROHNS-DISEASE - CASE-REPORT AND REVIEW OF THE LITERATURE

Esophagogastric fistula formation as a complication of esophageal Croh n's has been reported in only one case in the literature. In addition, only eight cases of esophageal fistulae of any type have been reporte d in the setting of Crohn's disease. Unlike the more often described s uperficial, aphthous disease of the esophagus, response of fistulae to medical therapy has been disappointing, and recurrence and progressio n are likely. Surgery remains the primary modality for refractory dise ase. The roles of salicylates, antibiotics, immunosuppressive agents, sealants, and intralesional steroid injections have not been well defi ned. We present a case of severe, refractory Crohn's disease with fist ula formation between the esophagus and stomach, and concomitant invol vement of the oropharynx, duodenum, terminal ileum, and cecum, (Am J G astroenterol 1998; 93:1381-1383. (C) 1998 by Am. Cell. of Gastroentero logy).