Published online Jun 16, 2015. doi: 10.12998/wjcc.v3.i6.479
Peer-review started: November 22, 2014
First decision: December 12, 2014
Revised: April 14, 2015
Accepted: April 27, 2015
Article in press: April 29, 2015
Published online: June 16, 2015
Crohn’s disease (CD) is a chronic idiopathic inflammatory disease of gastrointestinal tract characterized by segmental and transmural involvement of gastrointestinal tract. Ileocolonic and colonic/anorectal is a most common and account for 40% of cases and involvement of small intestine is about 30%. Isolated involvement of stomach is an extremely unusual presentation of the disease accounting for less than 0.07% of all gastrointestinal CD. To date there are only a few documented case reports of adults with isolated gastric CD and no reports in the pediatric population. The diagnosis is difficult to establish in such cases with atypical presentation. In the absence of any other source of disease and in the presence of nonspecific upper gastrointestinal endoscopy and histological findings, serological testing can play a vital role in the diagnosis of atypical CD. Recent studies have suggested that perinuclear anti-neutrophil cytoplasmic antibody and anti-Saccharomycescervisia antibody may be used as additional diagnostic tools. The effectiveness of infliximab in isolated gastric CD is limited to only a few case reports of adult patients and the long-term outcome is unknown.
Core tip: The stomach is rarely the sole or predominant site of Crohn’s disease (CD) accounting for less than 0.07% of all gastrointestinal CD. Serological testing and meticulous histopathological examination by excluding other causes of granulomatous gastritis can play a vital role to arrive at the correct diagnosis.