Crohn's Disease of the Upper Gastrointestinal Tract: Endoscopic and Histologic Characteristics and Prevalence of <I>Helicobacter pylori </I>Infection

Korean J Gastrointest Endosc > Volume 27(1); 2003 > Article

Korean Journal of Gastrointestinal Endoscopy 2003;27(1): 1-9.

상부 위장관 크론병: 내시경적, 조직학적 병변과 Helicobacter pylori의 유병률에 대한 연구

정용희·이동근^†·김효종·김윤화*·이병욱·한요셉·동석호·김병호·장영운·이정일·장 린

경희대학교 의과대학 소화기내과학교실, *진단병리학교실, ^†한림대학교 의과대학 소화기내과

Crohn's Disease of the Upper Gastrointestinal Tract: Endoscopic and Histologic Characteristics and Prevalence of Helicobacter pylori Infection

Yong Hee Joung, M.D., Dong Gun Lee, M.D.^†, Hyo Jong Kim, M.D., Yun Wha Kim, M.D.*, Bynung Ok Lee, M.D., Yo Seb Han, M.D., Seok Ho Dong, M.D., Byung Ho Kim, M.D., Young Woon Chang, M.D., Jung Il Lee, M.D. and Rin Chang, M.D.

Departments of Gastroenterology and *Pathology, Kyung Hee University College of Medicine, Seoul, ^†Department of Gastroenterology, Hallym Medical University, Chuncheon, Korea, Korea

Abstract

Background/Aims:
It is well known that Crohn's disease (CD) can affect all gastrointestinal tract. However, there was no report that evaluated upper gastrointestinal CD in Korea. Therefore, we assessed the endoscopic and histological characteristics of gastrointestinal CD and the prevalence of Helicobacter pylori infection in Korea.
Methods:
We examined forty-six patients who were diagnosed as having CD in Kyung Hee University Hospital. We analyzed the endoscopic and histological characteristics by endoscopic examination with biopsy and the prevalence of H. pylori infection. We also investigated the immunohistochemical characteristics of the biopsy specimen and assessed the effects of medications on both histologic and bacteriologic status.
Results:
High proportion (69.6%) of CD patients showed upper gastrointestinal mucosal alterations. Erosive endoscopic alteration was the most common finding with major involvement in the antrum and duodenum. In H. pylori negative CD patients, granuloma and focal gastritis were found in 30.6% and 44.4% of cases, respectively. There were no significant correlations between histologic features and clinical characeteristics of CD.
Conclusions:
We conclude that histologic demonstration of focal gastritis and/or granuloma on endoscopic biopsy specimens in oligosymptomatic patients, especially in H. pylori negative patients, might be considered as patients with possible CD. (Korean J Gastrointest Endosc 2003;27:1⁣9)

Key Words: Crohn's disease, Helicobacter pylori

주요어: 크론병, Helicobacter pylori