Crohn disease: early recognition and progress of aphthous lesions.

Abstract

To clarify the radiographic appearance of the initial change an dprogression in Crohn disease. Between 1984 and 1992, nine patients (seven men and two women, aged 16-34 years; mean, 20 years) with Crohn disease, who had evidence of only aphthous erosions or ulcers at the initial examination, underwent repeated radiography for up to 7 years 11 months (median, 4 years). In all patients, the stomach, duodenum, small intestine, and colorectum were involved, and the esophagus was affected in three patients. Subsequently, four of the nine patients had lesions that progressed from aphthous lesions to overt Crohn disease, including ileitis in two patients, colitis in one, and ileocolitis in one. Time intervals between the first visit and the progression varied from 9 months to 3 years 6 months. In all eight patients who underwent nutritional treatment, regression of the lesions was recognized, but three of the lesions progressed during interruption of the nutritional diet. Crohn disease may initially appear as diffuse aphthous lesions in the gastrointestinal mucosa.