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Acute duodenal Crohn's disease successfully managed with low-speed elemental diet infusion via nasogastric tube:A case report

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World Journal of Gastroenterology 2006年第4期12卷 649-651页

作者： TakayukiYamamoto MakiNakahigashi SatoruUmegae tatsushikitagawa KoichiMatsumoto Inflammatory Bowel Disease Center Yokkaichi Social Insurance Hospital10-8 HazuyamachoYokkaichiMie 510-0016Japan

Duodenal Crohn＇s disease is rare, and patients without obstruction are treated medically. We herein report one case whose duodenal Crohn＇s disease was successfully managed with low-speed elemental diet infusion through a nasogastric tube. A 28-year-old female developed acute duodenal Crohn＇s disease. Upper GI radiologic and endoscopic examinations showed a stricture in the duodenal bulb. Using the duodenal biopsy specimens, mucosal cytokine levels were measured; interleukin （IL）-1β, IL-6, IL-8, and tumor necrosis factor-α levels were remarkably elevated. For initial 2 wk, powdered mesalazine was orally given but it was not effective. For the next 2 wk, she was treated with low-speed elemental diet therapy using a commercially available ElentalTM, which was infused continuously through a nasogastric tube using an infusion pump. The tip of the nasogastric tube was placed at an immediate oral side of the pylorus. The infusion speed was 10 mL/h （usual speed, 100 mL/h）. After the 2-wk treatment, her symptoms were very much improved, and endoscopically, the duodenal stricture and inflammation improved. The duodenal mucosal cytokine levels remarkably decreased compared with those before the treatment. Although our experience was limited, lowspeed elemental diet infusion through a nasogastric tube may be a useful treatment for acute duodenal Crohn＇s disease.

关键词： Cytokine Duodenal Crohn's disease Elemental diet Inflammation Stricture

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