Gastroduodenitis associated with ulcerative colitis: A case report

Background: Ulcerative colitis (UC) is defined as a chronic inflammatory bowel disease that can occur in any part of the large bowel. In addition, UC affects only the large bowel except for backwash ileitis and pouchitis, whereas Crohn's disease (CD) affects the entire digestive tract. Inflammatory bowel disease (IBD) patients tend to be diagnosed with CD or indeterminate colitis when combined with gastric lesion. However, in recent years, some UC patients are reported to have various degrees of lesions in gastroduodenum. Here, we report a case of gastroduodenitis associated with UC (GDUC).

Case summary: A 25-year-old man with a history of Klippel-Trenaunay syndrome presented to the hospital with mucopurulent bloody stool and epigastric persistent colic pain for 2 wk. Continuous superficial ulcers and spontaneous bleeding were observed under colonoscopy. Subsequent gastroscopy revealed mucosa with diffuse edema, ulcers, errhysis, and granular and friable changes in the stomach and duodenal bulb, which were similar to the appearance of the rectum. After ruling out other possibilities according to a series of examinations, a diagnosis of GDUC was considered. The patient hesitated about intravenous corticosteroids, so he received a standardized treatment with pentasa of 3.2 g/d. After 0.5 mo of treatment, the patient's symptoms achieved complete remission. Follow-up endoscopy and imaging findings showed no evidence of recurrence for 26 mo.

Conclusion: The occurrence of gastrointestinal involvement in UC is rare, which may open a new window for studying the etiology and pathogenesis of UC. Physicians should consider broad differential diagnosis by endoscopic biopsy and laboratory examinations.

Keywords: Abdominal pain; Case report; Duodenitis; Gastritis; Gastroduodenitis; Ulcerative colitis.