Immunity, Inflammation and Disease · Published 2026-07-01 · DOI 10.1002/iid3.70491
Chaochao Chen, Yongrong Li, Yiyao Chen, Zhoutao He, Cheng Lan
ABSTRACT Background Upper gastrointestinal Crohn's disease (UGI‐CD) is rare, with an adult prevalence of 0.5%–4.0%. Its nonspecific symptomatology and the absence of clear diagnostic guidelines pose significant diagnostic challenges. Case Presentation We present two patients with UGI‐CD treated at Hainan General Hospital. In the first case, a 47‐month diagnostic delay led to disease progression and surgical intervention. In the second case, prompt diagnosis of a duodenal ulcer enabled medical management, avoiding surgery. Both patients received infliximab and achieved remission. Conclusion These cases highlight diagnostic challenges in UGI‐CD and offer three key lessons: (i) UGI‐CD should be suspected in refractory, Helicobacter pylori‐negative duodenal ulcers; (ii) an endoscopic‐radiologic mismatch may occur; and (iii) we propose a diagnostic algorithm to assist early recognition, though it has not been prospectively validated. Given the descriptive nature of this two‐case series, these findings are hypothesis‐generating and require further validation.
Abstract from DOAJ. Public domain (CC0 1.0).
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Chen, C., Li, Y., Chen, Y., et al. (2026). The Diagnostic Challenge of Crohn's Disease With Initial Duodenal Involvement: Two Cases and Literature Review. Immunity, Inflammation and Disease. https://doi.org/10.1002/iid3.70491