Crohn's disease of the duodenum (transmural duodenitis): clinical manifestations. Report of 11 cases.

Abstract

Data from 11 patients with Crohn's disease of the duodenum (transmural duodenitis), seen from 1965–1970, are reported. For all, duodenal involvement predominated with a) symptoms of duodenal obstruction (6 patients); b) symptoms of duodenal ulceration (3 patients); c) or both (2 patients). Six had previous histories of transmural enteritis or colitis; for 5, duodenal involvement was the first manifestation of transmural enteritis. All subsequently had other involvement by transmural enteritis: 8 ileal, 5 colonic, 3 cutaneous fistulae and 3 perirectal abscesses. Ten had operations for duodenal disease and had bypass procedures; no vagotomy was done. Eight have done well and only 1 required further operations. Transmural duodenitis should be suspected for patients with symptoms of duodenal ulceration or obstruction and known transmural enteritis or colitis; duodenal involvement may be the first manifestation of transmural enteritis.