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. 2024 Mar 20;14(1):88619.
doi: 10.5662/wjm.v14.i1.88619.

Duodenal Crohn's disease: Case report and systematic review

Muniratu Amadu  1 , Jonathan Soldera  2
Affiliations

Duodenal Crohn's disease: Case report and systematic review

Muniratu Amadu et al. World J Methodol. .

Abstract

Background: Inflammatory bowel disease, including ulcerative colitis, microscopic colitis, and Crohn's disease (CD), has a global impact. This review focuses on duodenal CD (DCD), a rare subtype affecting the duodenum. DCD's rarity and asymptomatic nature create diagnostic challenges, impacting prognosis and patient well-being. Delayed diagnosis can worsen DCD outcomes.

Aim: To report a rare case of DCD and to discuss the diagnostic challenges and its implications on prognosis.

Methods: A systematic literature search, following the PRISMA statement, was conducted. Relevant studies were identified and analysed using specific Medical Subject Terms (MeSH) from PubMed/MEDLINE, American Journal of Gastroenterology, and the University of South Wales database. Data collection included information from radiology scans, endoscopy procedures, biopsies, and histopathology results.

Results: The review considered 8 case reports and 1 observational study, involving 44 participants diagnosed with DCD, some of whom developed complications due to delayed diagnosis. Various diagnostic methods were employed, as there is no gold standard workup for DCD. Radiology scans [magnetic resonance imaging (MRI), computed tomography (CT), and upper gastrointestinal X-ray], endoscopy procedures (colonoscopy and esophagogastroduodenoscopy), biopsies, and clinical suspicions were utilized.

Conclusion: This review discusses DCD diagnosis challenges and the roles of CT, MRI, and fluoroscopy. It notes their limitations and compares findings with endoscopy and histopathology studies. Further research is needed to improve diagnosis, emphasizing scan interpretation, endoscopy procedures, and biopsies, especially in high-risk patients during routine endoscopy.

Keywords: Crohn’s disease; Diagnostic challenges; Duodenum; Inflammatory bowel diseases; Prognosis.

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Conflict of interest statement

Conflict-of-interest statement: All authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Endoscopy and colonoscopy. A: Upper digestive endoscopy, duodenum, second portion. Small aphthous ulcers, diffuse in the involved region; B: Colonoscopy, terminal ileum. Aphthous ulcers in involved region.
Figure 2
Figure 2
Endoscopy and colonoscopy. A: Upper digestive endoscopy, duodenum, second portion; B: Colonoscopy, terminal ileum. Normal mucosa after six months of methotrexate and adalimumab therapy.
Figure 3
Figure 3
PRISMA- P protocol flow chart for systematic review. DCD: Crohn’s disease.
See this image and copyright information in PMC

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