SURGICAL-TREATMENT FOR DUODENAL INVOLVEMENT IN CROHNS-DISEASE - REPORT OF A CASE

A 29-year-old woman was hospitalized with a 1-month history of postpra ndial epigastric pain, nausea, and vomiting, An upper gastrointestinal tract X-ray series showed a marked narrowing of the pyloric region, A histological examination of duodenal mucosal biopsy samples showed gr anulomatous inflammation, and thus a diagnosis of intrinsic duodenal C rohn's disease was made, A second upper gastrointestinal tract X-ray r evealed a persistent gastric outlet obstruction, At laparotomy, the du odenal wall was found to be thickened over a distance measuring 3.5 cm in length from the pyloric ring, A longitudinal incision was made ol er the entire length, up to 5.5 cm beyond the pyloric ring on either s ide, while Finney-type anastomosis was also performed, A postoperative upper gastrointestinal tract X-ray showed an improvement in the gastr oduodenal passage. Enteral nutrition therapy was provided postoperativ ely. Omeprazole was administered at a dose of 20 mg/day for 2 months. The patient currently remains on maintenance therapy with famotidine a t 20 mg/day and is clinically doing well.