Clinical Analysis Of 29 Cases Of Crohn's Disease Involving Upper Gastrointestinal

Objective: This study retrospectively analyzed the clinical features of upper gastrointestinal Crohn's disease(CD)involving the upper gastrointestinal,aiming to improve the understanding and diagnosis and treatment of Crohn's disease involving the upper gastrointestinal,and to reduce missed diagnosis and misdiagnosis.Method: 96 cases of CD patients admitted and confirmed in the first digestive department of Shengjing Hospital affiliated to China Medical University from January 1,2010 to December 31,2018 were included,the clinical characteristics of patients with and without CD involvement in the upper gastrointestinal were compared and statistically anaiyzed.Results:According to the Montreal classification standard,there were 0 cases(0%)of colon(L2)involvement in CD group with upper gastrointestinal involvement and 11cases(16 42%)of colon(L2)involvement in the CD group without upper gastrointestinal involvement,and the difference between the two groups was statisticafly significant(P<0.05).Perianal lesions were first symptom diagnosed in 4 cases(13.79%)in the CD group with upper gastrointestinal involvement,and in 1 case(1.49%)in the CD group without upper gastrointestinal involvement.The difference between the two groups was statistically significant(P<0.05).Twenty patients(68.97%)had weight loss in the CD group with upper gastrointestinal involvement,and 31 patients(56.52%)had weight loss in the CD group without upper gastrointestinal tract.The difference between the two groups was statistically significant(c2=4.187,P<0.05).The average BMI of the CD group with upper gastrointestinal involvement was(18.56±2.24),while the average BMI of the CD group without upper gastrointestinal involvement was(20.99±5.44).The difference between the two groups was statistically significant(t=-3.098,P < 0.05).There were 11 cases(37.93%)of intestinal obstruction complicated in the CD group with upper gastrointestinal involvement,and 12 cases(17.91%)of intestinal obstruction complicated in the CD group without upper gastrointestinal involvement(P < 0.05).The average value of CRP in the upper gastrointestinal group was(13.39 ±24.62)mg/L,while the average value of CRP in the group without upper gastrointestinal involvement was(38.32±36.99)mg/L.The difference between the two groups was statistically significant(t=-3.10;P<0.01).The mean value of erythrocyte sedimentation rate(ESR)of CD group with upper gastrointestinal involvement was(23.41 ±18.06)mg/L,while the mean value of ESR of the CD group widiout upper gastrointestmal involvement was(37.60±23.45)mg/L.The difference between the two groups was statistically significant(t=-3 163.P<0.01).In the CD group with upper gastrointestinal involvement,7 cases(24.14%)underwent partial intestinal resection while in the CD group without upper gastrointestinal involvement 7 cases(10.45%)underwent partial intestinal resection.The difference between the two groups was statistically significant.(2 =4.509,P<0.05).Conclusion: Compared with the CD group without involvement in the upper gastrointestinal,L2 in the CD group with involvement in the upper gastrointestinal tract was less involved,the increase in CRP and ESR was not significant,the patients with symptoms of perianal lesions were more,the symptoms of emaciation were obvious,the rate of intestinal obstruction was high,the rate of intestinal resection was high,and the prognosis was poor.Clinically,you should be vigilant to avoid missed diagnosis,misdiagnosis,and delay in treatment.