title: [Pyloric stenosis as a presenting clinical pattern of Crohn's disease].
abstract: BACKGROUND
  Gastroduodenal involvement in Crohn's disease (CD) is relatively rare (0.5-13%) and occasionally causes pyloric stenosis, for which medical therapy may be ineffective and surgery may be required. With more frequent use of upper endoscopy, however, upper gastrointestinal involvement has been found to be more common than previously suspected. About one third of the patients with symptomatic gastroduodenal CD undergo surgery, most of them for obstruction. Gastroenterostomy with vagotomy is the surgical treatment of choice. Resection, strictureplasty or balloon dilatation maybe performed in selected patients.
  
  
  METHODS
  We report a 50-year-old woman patient with recurrent vomiting especially after eating and epigastric discomfort with dyspepsia, abdominal pain, with initially misdiagnosed pyloric CD that three years later developed colonic stenosis.
  
  
  CONCLUSIONS
  Clinics should be aware of the possibility that in young and middle aged adults such upper gastrointestinal symptoms as epigastric discomfort, vomiting and weight loss may occur as a initial manifestation of CD or as an extension of the disease.
authors.affiliation: Departamento de Cirugía de Colon y Recto, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Distrito Federal, México.
authors.forename: Omar Eduardo
authors.initials: OE
authors.lastname: Chávez-Velarde
authors.forename: Daniel Alejandro
authors.initials: DA
authors.lastname: Hernández-Ramírez
authors.forename: Rafael
authors.initials: R
authors.lastname: Martínez-Gen
authors.forename: Luz María
authors.initials: LM
authors.lastname: Gómez-Jiménez
mesh_terms: D003424:Crohn Disease / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D008875:Middle Aged; D011707:Pyloric Stenosis / Q000209:etiology*