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Open Access Case report

Isolated Crohn’s disease of the esophagus with esophago-mediastinal fistula formation

Wuping Wang, Yunfeng Ni, Changkang Ke, Qingshu Cheng, Qiang Lu* and Xiaofei Li*

Author Affiliations

Department of Thoracic Surgery, Tangdu Hospital, The Fourth Military Medical University, Xi’an, PR China

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World Journal of Surgical Oncology 2012, 10:208  doi:10.1186/1477-7819-10-208

Published: 3 October 2012

Abstract

Isolated Crohn’s disease of the esophagus is rare, and accurate diagnosis and treatment in its early course are difficult. Most cases are often found very late, when severe strictures or other complications have occurred. We report the case of a male 60-year-old patient with complaints of progressive dysphagia for more than two months and the sudden appearance of heartburn for seven consecutive days. Clinical examination revealed severe esophageal stricture with a suspected fistula and mediastinitis. The patient received a successful esophagectomy. The resected specimen and pathological results confirmed a deep linear ulcer, chronic and noncaseating granulomatous inflammation, as well as a circular stricture of the esophagus with fistula into the mediastinum due to isolated esophageal Crohn’s disease.

Keywords:
Crohn’s disease of esophagus; Esophago-mediastinal fistula; Stricture; Noncaseating granulomas