Systematic Reviews
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Methodol. Mar 20, 2024; 14(1): 88619
Published online Mar 20, 2024. doi: 10.5662/wjm.v14.i1.88619
Duodenal Crohn’s disease: Case report and systematic review
Muniratu Amadu, Jonathan Soldera
Muniratu Amadu, Jonathan Soldera, Department of Gastroenterology, University of South Wales, Cardiff CF37 1DL, United Kingdom
Author contributions: Amadu M and Soldera J participated in the concept and design research, drafted the manuscript and contributed to data acquisition, analysis and interpretation; Soldera J contributed to study supervision; all authors contributed to critical revision of the manuscript for important intellectual content.
Conflict-of-interest statement: All authors declare no conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jonathan Soldera, MD, PhD, Instructor, Department of Gastroenterology, University of South Wales, University of South Wales, Cardiff CF37 1DL, United Kingdom. jonathansoldera@gmail.com
Received: October 1, 2023
Peer-review started: October 1, 2023
First decision: December 11, 2023
Revised: December 16, 2023
Accepted: January 18, 2024
Article in press: January 18, 2024
Published online: March 20, 2024
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: Inflammatory bowel diseases, Crohn’s disease, Duodenum, Diagnostic challenges, Prognosis

Core Tip: This systematic review explores the diagnostic challenges and implications of duodenal Crohn’s disease (DCD), a rare subtype. Delayed diagnosis can worsen DCD outcomes, emphasizing the need for improved diagnostic methods. The study considers various diagnostic approaches, including radiology scans and endoscopy procedures, highlighting their limitations and the importance of biopsy and histopathology. Further research is essential to enhance DCD diagnosis, particularly in high-risk patients during routine endoscopy.