| Abstract [eng] |
Crohn‘s disease is a chronic idiopathic inflammatory bowel disease. Although the disease can affect any part of the digestive tract, involvement of the esophagus is rare. This article presents the clinical case of a 55-year-old man diagnosed with Crohn‘s disease with esophageal involvement. The patient comes for a scheduled appointment with gastroenterologist after 3 months of diarrhea. After evaluation of patient‘s anamnesis and tests, the cause diarhhea was still not clear and it was decided to prescribe the patient antimicrobial therapy with ciprofloxacin. 2 weeks after the prescribed treatment, the patient developed new symptoms associated with damage to the esophagus - dysphagia, odynophagia, discomfort in the sternum area, and diarrhea persisted. An esophagogastroduodenoscopy was performed, and deep ulcers were identified in esophageal mucosa. Test results were differentiated between drug-induced esophageal mucosal damage (recent use of ciprofloxacin), infectious esophagitis or esophagitis of other etiology. Esomerazole was administered. However, diarrhea persisted, right lower abdominal pain and subfebrile fever developed and the patient was admitted to hospital. The endoscopic examination (esophagogastroduodenoscopy, colonoscopy) and biopsies was repeated and the histological results showed ulcerative granulomatous esophagitis, chronic gastritis with intestinal metaplasia and granulomatous reaction, chronic active duodenitis and ileitis and chronic active inflammation in the colon. After evaluation of the results, a diagnosis of Crohn‘s disease with esophageal involvement was made. In order to diagnose Crohn‘s disease of the esophagus, it is important to evaluate the patient‘s anamnesis, carefully examine the esophageal mucosa endoscopically, determine the shape, depth and localisation of ulcers and check whether granulomas are present. Esophageal Crohn‘s disease is a rare form of Crohn‘s disease and its diagnosis remains a challenge for specialists due to the wide spectrum of Crohn‘s disease lesions and difficult differential diagnosis. |
