The American Journal of Digestive Diseases

, Volume 17, Issue 3, pp 191–198 | Cite as

Crohn's disease of the duodenum (transmural duodenitis): Clinical manifestations

Report of 11 cases
  • Richard G. Farmer
  • William A. Hawk
  • Rupert B. TurnbullJr.


Data from 11 patients with Crohn's disease of the duodenum (transmural duodenitis), seen from 1965–1970, are reported. For all, duodenal involvement predominated with a) symptoms of duodenal obstruction (6 patients); b) symptoms of duodenal ulceration (3 patients); c) or both (2 patients). Six had previous histories of transmural enteritis or colitis; for 5, duodenal involvement was the first manifestation of transmural enteritis. All subsequently had other involvement by transmural enteritis: 8 ileal, 5 colonic, 3 cutaneous fistulae and 3 perirectal abscesses. Ten had operations for duodenal disease and had bypass procedures; no vagotomy was done. Eight have done well and only 1 required further operations. Transmural duodenitis should be suspected for patients with symptoms of duodenal ulceration or obstruction and known transmural enteritis or colitis; duodenal involvement may be the first manifestation of transmural enteritis.


Public Health Clinical Manifestation Ileal Duodenal Ulceration Previous History 


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  1. 1.
    Crohn BB: Granulomatous disease of the small and large bowel. A historical survey. Gastroenterology 52:767–772, 1967PubMedGoogle Scholar
  2. 2.
    Brooke BN: Granulomatous diseases of the intestine. Lancet 2:746–749, 1959Google Scholar
  3. 3.
    Lockhart-Mummery HE, Morson BC: Crohn's disease (regional enteritis) of the large intestine and its distinction from ulcerative colitis. Gut 1:87–105, 1960PubMedGoogle Scholar
  4. 4.
    Lindner AE, Marshak RH, Wolf BS, et al: Granulomatous colitis: A clinical study. N Engl J Med 269:379–385, 1963Google Scholar
  5. 5.
    Lennard-Jones JE, Lockhart-Mummery HE, Morson BC: Clinical and pathological differentiation of Crohn's disease and proctocolitis. Gastroenterology 54:1162–1170, 1968PubMedGoogle Scholar
  6. 6.
    Farmer RG, Hawk WA, Turnbull RB Jr: Regional enteritis of the colon: a clinical and pathologic comparison with ulcerative colitis. Am J Dig Dis 13:501–514, 1968PubMedGoogle Scholar
  7. 7.
    Idem: The clinical differentiation of transmural (regional) colitis from ulcerative colitis. Bibl Gastroenterol 9:94–103, 1970Google Scholar
  8. 8.
    Gottlieb C, Alpert S: Regional jejunitis. Am J Roentgenol Radium Ther Nucl Med 38:881–883, 1937Google Scholar
  9. 9.
    Comfort MW, Weber HM, Baggenstoss AH, et al: Nonspecific granulomatous inflammation of the stomach and duodenum: its relation to regional enteritis. Am J Med Sci 220:616–632, 1950PubMedGoogle Scholar
  10. 10.
    Brown CH, Sims JR Jr: Regional enteritis involving the duodenum: report of 2 cases. Cleve Clin Q 21:95–102, 1954Google Scholar
  11. 11.
    Segal G, Serbin R: Regional enteritis involving the duodenum. Gastroenterology 30:503–507, 1956PubMedGoogle Scholar
  12. 12.
    McGarity WC: Regional enteritis of the duodenum. Surg Gynecol Obstet 105:203–209, 1957PubMedGoogle Scholar
  13. 13.
    Keats TE, Brady RM: Duodenal involvement in regional enteritis. Am J Roentgenol Radium Ther Nucl Med 77:639–643, 1957PubMedGoogle Scholar
  14. 14.
    Durrance FY: Regional enteritis of the duodenum. Am J Roentgenol Radium Ther Nucl Med 88:658–661, 1962PubMedGoogle Scholar
  15. 15.
    Pryse-Davies J: Gastro-duodenal Crohn's disease. J Clin Pathol 17:90–94, 1964PubMedGoogle Scholar
  16. 16.
    Law SW, Searle NB, Barton HL, et al: Regional enteritis of the duodenum; report of a case and review of the literature. Arch Surg 89:562–569, 1964PubMedGoogle Scholar
  17. 17.
    Lust FJ, Crohn BB, Hartman J: Nonspecific granulomatous disease involving duodenum, jejunum and ileum. Am J Gastroenterol 43:40–48, 1965PubMedGoogle Scholar
  18. 18.
    Van Patter WN, Bargen JA, Dockerty MR, et al: Regional enteritis. Gastroenterology 26:347–450, 1954PubMedGoogle Scholar
  19. 19.
    Edwards AM, Michalyshyn B, Sherbaniuk RW, et al: Regional enteritis of the duodenum: a review and report of five cases. Can Med Assoc J 93:1283–1295, 1965PubMedGoogle Scholar
  20. 20.
    Jones GW Jr, Dooley MR, Schoenfield LJ: Regional enteritis with involvement of the duodenum. Gastroenterology 51:1018–1022, 1966PubMedGoogle Scholar
  21. 21.
    Roberts SM, Hamilton WW: Regional enteritis of the duodenum. Radiology 86:881–885, 1966PubMedGoogle Scholar
  22. 22.
    Kusakcioglu O, Norton RA: Granulomatous duodenitis, clubbed digits and psoriasis: report of a case. Lahey Clin Found Bull 16:191–193, 1967PubMedGoogle Scholar
  23. 23.
    Friedman IH: Regional duodenitis. NY State J Med 67:461–464, 1967Google Scholar
  24. 24.
    Abourjaily GS, Carroll M, Maher E: Operative management of an unusual case of regional enteritis with duodenal involvement. Am J Gastroenterol 51:55–60, 1969PubMedGoogle Scholar
  25. 25.
    Van der Hoeden R, Bremer A, Parmentier R: Maladie de Crohn a localisations pyloroduodenale et ileocolique. Acta Gastroenterol Belg 32:171–184, 1969PubMedGoogle Scholar
  26. 26.
    Nelson SW: Some interesting and unusual manifestations of Crohn's disease (regional enteritis”) of the stomach, duodenum, and small intestine. Am J Roentgenol Radium Ther Nucl Med 107:86–101, 1969PubMedGoogle Scholar
  27. 27.
    Wise L, Kyriakos M, McCown A, et al: Crohn's disease of the duodenum. A report and analysis of eleven new cases. Am J Surg 121:184–194, 1971PubMedGoogle Scholar
  28. 28.
    Burgess JN, Legge DA, Judd ES: Surgical treatment of regional enteritis of the duodenum. Surg Gynecol Obstet 132:628–630, 1971PubMedGoogle Scholar
  29. 29.
    Hawk WA, Turnbull RB Jr, Farmer RG: Regional enteritis of the colon. Distinctive features of the entity. JAMA 201:738–746, 1967PubMedGoogle Scholar
  30. 30.
    Bruno MS, Fine HD: Primary malignant and benign tumors of the duodenum. Arch Intern Med 125:670–679, 1970PubMedGoogle Scholar

Copyright information

© Harper & Row, Publishers, Incorporated 1972

Authors and Affiliations

  • Richard G. Farmer
    • 1
  • William A. Hawk
    • 1
  • Rupert B. TurnbullJr.
    • 1
  1. 1.From the Departments of Gastroenterology, Anatomic Pathology and Colon and Rectal SurgeryThe Cleveland Clinic Foundation and The Cleveland Clinic Educational FoundationCleveland

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