case_images: PMC11294937_01
case_images: First esophagogastroduodenoscopy in our centre showing an ulcerative gastritis with gastric outlet stenosis due to large ulcers at the transition between pylorus and bulbus, which could only be passed with a nasogastric endoscope (diameter 5.4 millimeter) (1) and duodenal ulcerations with intermediate normal appearing mucosa (2). Control esophagogastroduodenoscopy six months after induction with Infliximab and azathioprine showing no residual inflammation in the antrum (3) or duodenum (4). Pyloric opening and transition between pylorus and bulbus could be easily passed with a gastric endoscope (diameter 9.9 millimeter).
case_images: fmed-11-1388940-g001.jpg
case_images: PMC11294937_01_fmed-11-1388940-g001.jpg
case_images: fig1
case_images: Control EGD after presentation at our center showed similar macroscopic findings despite PPI treatment: diffuse gastritis with gastric outlet stenosis due to large ulcers at the transition between pylorus and bulbus, which could only be passed with a nasogastric endoscope (diameter 5.4 millimeter) (Figure 1). The gastric biopsies now showed a few small non-caseating granulomas, suggestive of Crohn's disease (CD), since other causes of granulomatous gastritis (GG), i.e., sarcoidosis, malignancy, and infectious diseases such as tuberculosis or Whipple's disease, had already been thoroughly ruled out (Figure 1).