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Article
May 3, 1976

Gastroduodenal Involvement, With Pain, Vomiting, and Weight Loss

Author Affiliations

From the departments of medicine (Dr Ansari), radiology (Dr Anderson), and surgery (Drs Hoppes and Henrikson), Metropolitan Medical Center, Minneapolis.

JAMA. 1976;235(18):2013-2014. doi:10.1001/jama.1976.03260440065034
Abstract

History  A 52-year-old woman complained of epigastric pain, early satiety, post-prandial vomiting, and weight loss of six months' duration. An upper gastrointestinal roentgenographic series was performed (Fig 1 and 2). Two years earlier she had undergone abdominal surgery for a related illness.

Diagnosis  Crohn disease of the stomach and duodenum.

Comment  Figures 1A and B demonstrate rigidity, narrowing, and irregularity of the antrum, pylorus, and duodenum. A "cobblestone" or "string of pearls" appearance of the mucosa in the body of the stomach is clearly seen in Fig 1C and D and 2. Figure 3 shows pseudopolypoid nodulation of the mucosa in the resected specimen of the stomach that closely parallels with the roentgenographic pattern shown in Fig 1C and D. Figure 4 illustrates the histologic appearance, showing foci of chronic inflammatory reaction in the submucosa. Granulomas are easily identified and contain many giant cells. No central caseation nor acid-fast bacilli

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