ABSTRACT
This chapter describes the surgical management of the different locations of upper gastrointestinal Crohn’s disease (UGI CD): oropharyngeal, oesophageal and gastroduodenal. A high prevalence of UGI CD is more often reported in children and adolescents than in adults. UGI CD is most frequently asymptomatic or associated with uncommon signs, its prevalence ranges from 0.5% to 13%. The principles of management of UGI CD remains similar to those of ileo-colonic manifestations where medical treatment is the mainstay of therapy and where surgery is only indicated in obstruction or complications: perforation and fistula. Oropharyngeal lesions are most frequently associated with proximal UGI disease and/or anoperineal CD. The diagnosis of oesophageal CD is difficult because radiological, endoscopic, and histologic features are not pathognomonic, particularly when the disease is limited to the oesophagus. As the majority of patients had CD at another GI location, they are often already being treated with anti-inflammatory or immunosuppressive drugs.
