title: Refractory duodenal Crohn's disease successfully treated with infliximab.
abstract: Crohn's disease (CD) may involve any part of the gastrointestinal tract, from the mouth to the anus. Approximately >90% of cases occur in the small bowel and colon. Upper gastrointestinal involvement, especially duodenal manifestation, is relatively rare. Therefore, adequate medical treatment for duodenal CD has not yet been established. We report a case of CD with duodenal involvement. A 46-year-old man with Crohn's ileocolitis presented to our hospital with right upper quadrant pain. An endoscopy showed a deep excavated ulcer with deformity at the duodenal bulb, and he was initially treated with azathioprine (1 mg/kg), Pentasa (3.0 g/day), and a proton pump inhibitor for 1 year. However, the deep ulcer did not heal. Therefore, infliximab infusion therapy was initiated, and the duodenal lesion completely resolved on follow-up esophagogastroduodenoscopy. We report a case of duodenal CD that completely resolved following infliximab infusion, with a review of the literature.
authors.affiliation: Department of Internal Medicine, Eulji University School of Medicine, Eulji Medical Center, Seoul, Korea.
authors.forename: You Lim
authors.initials: YL
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Eulji University School of Medicine, Eulji Medical Center, Seoul, Korea.
authors.forename: Young Sook
authors.initials: YS
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Eulji University School of Medicine, Eulji Medical Center, Seoul, Korea.
authors.forename: Eun Kyoung
authors.initials: EK
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Eulji University School of Medicine, Eulji Medical Center, Seoul, Korea.
authors.forename: Dae Rim
authors.initials: DR
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Eulji University School of Medicine, Eulji Medical Center, Seoul, Korea.
authors.forename: Gyu Sik
authors.initials: GS
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Eulji University School of Medicine, Eulji Medical Center, Seoul, Korea.
authors.forename: Sang Bong
authors.initials: SB
authors.lastname: Ahn
authors.affiliation: Department of Internal Medicine, Eulji University School of Medicine, Eulji Medical Center, Seoul, Korea.
authors.forename: Seong Hwan
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Eulji University School of Medicine, Eulji Medical Center, Seoul, Korea.
authors.forename: Yun Ju
authors.initials: YJ
authors.lastname: Jo
keywords: Crohn's disease; Duodenum; Infliximab