Work

Diagnostic value of focally enhanced gastritis and focally active inflammation in adult crohn’s disease

Year: 2026

Type: article

Abstract: Crohn’s disease (CD) predominantly affects the terminal ileum and colon. Upper gastrointestinal (UGI) tract involvement in CD is uncommon, and its clinicopathological profile remains inadequately studied. This study aimed to investigate the characteristics and diagnostic value of two histological features: focally enhanced gastritis (FEG) and focally active inflammation (FAI), in adult CD. A total of 136 patients with CD were retrospectively included in this study. UGI endoscopies and histological reviews were performed. One specimen was routinely obtained from the gastric body and angulus, while two specimens were collected from each of the distal esophagus, gastric antrum, duodenal bulb, and descending duodenum. FEG and/or FAI were identified in 33% of patients, with a significantly higher detection rate in males. The number of patients with FEG and/or FAI who also had granulomas was significantly greater than those without FEG or FAI. The detection rate of gastric FAI was similar to that in the duodenum and significantly higher than in the esophagus, while the detection rate of gastric granuloma was significantly higher than those in the duodenum and esophagus. The detection rate of FEG and/or FAI was significantly higher than those of noncaseating granulomas in the stomach and duodenum. Additionally, CD patients with FEG and/or FAI had a significantly higher detection rate of endoscopic ulcers. This study suggests the value of FEG and/or FAI may serve as useful auxiliary indicators for an increased risk of developing CD. Further controlled studies are needed to confirm their diagnostic utility and to improve the management of CD patients with UGI involvement. Not applicable.

Source: BMC Gastroenterology

DOI: 10.1186/s12876-026-05312-4