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Canadian Journal of Gastroenterology
Volume 8 (1994), Issue 2, Pages 101-104
http://dx.doi.org/10.1155/1994/764097
Brief Communication

Aphthous Esophagael Ulceration: A Novel Presentation of Crohn’s Disease?

Paul L Beck, Philip K Blustein, and Melvin A Andersen

Departments of Medicine and Pathology, University of Calgary, Calgary, Alberta, Canada

Received 24 June 1993; Accepted 3 November 1993

Copyright © 1994 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Crohn’s disease (CD) commonly presents as involvement of the small bowel or colon - the esophagus is rarely involved. The authors describe the case of a 45-year-old woman who presented with odynophagia and was found to have aphthous ulcers of the esophagus. On questioning, she admitted to three to four episodes of nonbloody diarrhea, each lasting less than one week, over the past two years. The patient denied other symptoms of gastrointestinal, collagen-vascular, respiratory or cardiovascular disease. Viral, fungal and bacterial cultures of blood, stool and tissue biopsies were all negative. A small bowel enema showed inflammation of the distal ileum. Colonoscopy revealed patchy areas of inflammation of the colon and distal ileum. Biopsies from the esophagus, duodenum, terminal ileum and colon showed chronic inflammation, lymphoid aggregates, goblet cell hyperplasia (in the colon) and crypt abscesses. Giant cells, granulomas and fissures were not evident in any of the biopsies. The patient failed to respond to a three-week course of omeprazole, but her symptoms resolved within three days of starting prednisone. The exact cause of the esophageal ulcerations is unknown but most likely is CD of the esophagus.