摘要
Duodenal Crohn＇s disease is rare, and patients without obstruction are treated medically. We herein report one case whose duodenal Crohn＇s disease was successfully managed with low-speed elemental diet infusion through a nasogastric tube. A 28-year-old female developed acute duodenal Crohn＇s disease. Upper GI radiologic and endoscopic examinations showed a stricture in the duodenal bulb. Using the duodenal biopsy specimens, mucosal cytokine levels were measured; interleukin （IL）-1β, IL-6, IL-8, and tumor necrosis factor-α levels were remarkably elevated. For initial 2 wk, powdered mesalazine was orally given but it was not effective. For the next 2 wk, she was treated with low-speed elemental diet therapy using a commercially available ElentalTM, which was infused continuously through a nasogastric tube using an infusion pump. The tip of the nasogastric tube was placed at an immediate oral side of the pylorus. The infusion speed was 10 mL/h （usual speed, 100 mL/h）. After the 2-wk treatment, her symptoms were very much improved, and endoscopically, the duodenal stricture and inflammation improved. The duodenal mucosal cytokine levels remarkably decreased compared with those before the treatment. Although our experience was limited, lowspeed elemental diet infusion through a nasogastric tube may be a useful treatment for acute duodenal Crohn＇s disease.
十二指肠的 Crohn 的疾病是稀罕的，并且没有阻塞的病人是对待的医学上。我们此处报导谁的一个案例十二指肠的 Crohn 的疾病成功地通过一个 nasogastric 试管与低速度的元素的食谱注入被管理。28 岁的女性得了尖锐十二指肠的 Crohn 的疾病。上面的官方补给的放射线学、内视镜的考试在十二指肠冠显示出苛评。用十二指肠的活体检视标本，粘膜 cytokine 层次被测量；interleukin (IL )-1beta, IL-6， IL-8，和肿瘤坏死 factor-alpha 层次显著地被提高。为起始 2 wk，粉状的 mesalazine 口头上地被给，但是它不是有效的。为下一 2 wk，她用商业地可得到的 Elental (TM ) 与低速度的元素的食谱治疗被对待，它用注入泵通过一个 nasogastric 试管连续地被灌输。nasogastric 试管的尖端被放在幽门的一个立即的口头的方面。注入速度是 10 mL/h (平常的速度， 100 mL/h ) 。在 2-wk 治疗以后，她的症状非常被改进，并且内视镜的联盟者，十二指肠的苛评和发炎改善了。十二指肠的粘膜 cytokine 层次显著地在处理前与那些相比减少了。尽管我们的经验是有限的，通过一个 nasogastric 试管的低速度的元素的食谱注入可以是为尖锐十二指肠的 Crohn 的疾病的一个有用处理。
