Ascitis quilosa secundaria a cirrosis hepática. Reporte de un caso

Upper gastrointestinal lesions secondary to Crohn’s disease become resistant to treatment in up to 21% of the cases, have complete clinical and endoscopic remission in 57%, and present at least one relapse of symptoms and lesions in 21%.10 In our case, medical treatment was established after the procedure, resulting in lesion and symptom remission. And finally, we can conclude that oropharyngeal and esophageal involvement in Crohn’s disease is rare and represents a diagnostic challenge due to the scant specificity of the clinical manifestations (aphthous ulcers), as well as the histologic findings (absence of granulomas), and also to the limited value of endoscopy and biopsy in that location, leading to late diagnosis with the consequent therapeutic and prognostic implications. In cases such as ours, with oral lesions that do not respond to symptomatic treatment, with no accurate diagnosis, and with a biopsy excluding malignancy, the possibility of inflammatory bowel disease should be considered. Endoscopic and colonoscopic studies directed at discovering associated lesions primarily in the terminal ileum should be performed to make a correct diagnosis and begin early medical treatment. In this manner, remission is achieved and the progression into more advanced forms of the disease or the appearance of complications that require surgical treatment in a clinical situation of greater morbidity and mortality for the patient are prevented.