Crohn's disease of the esophagus: Report of a case

We report herein the case of a 27-year-old man with Crohn's disease of the esophagus, The patient presented with large ulcers in the esophagus for whi ch treatment based on a diagnosis of reflux esophagitis was commenced, Alth ough his symptoms were initially resolved, the ulcers did not improve and h e was readmitted to hospital 3 months later for progressive heartburn. An e sophagoscopy revealed large ulcers in the esophagus, and a colonoscopy reve aled a longitudinal ulcer in the terminal ileum, Histological examination o f specimens from the terminal ileum showed severe inflammation without gran uloma formation, which led to a diagnosis of Crohn's disease. The oral admi nistration of prednisolone and salazosulfapyridine controlled his symptoms and the esophageal ulcers were observed to be healing 2 weeks after this tr eatment was initiated. A review of the English literature revealed only 77 cases of this disease. Isolated esophageal lesions were reported in ten pat ients (13.0%), none of which were able to be diagnosed as Crohn's disease p reoperatively. Ileocolic lesions developed after esophageal lesions in only five patients (6.5%) including ours. In the remaining 62 patients (80.5%), ileocolic lesions had existed synchronous with or prior to the esophageal lesions. This suggests that ileocolic lesions may often coexist in Crohn's patients with esophageal lesions, and that examination of the terminal ileu m must be performed to confirm a diagnosis of Crohn's disease of the esopha gus.