The presence in the esophagus of three distinct entities--Barrett's mucosa, Crohn's disease, and adenocarcinoma--is a very rare finding. In a 60-year-old man with a long history of heartburn and recently developed dysphagia, narrowing of the distal esophagus was found to be related to the presence of Barrett's mucosa. A short time later repeated endoscopy revealed adenocarcinoma in this area. The patient underwent esophagogastrectomy and died a few days after surgery. Findings in the surgical specimen and upon autopsy were consistent with isolated Crohn's disease of the distal esophagus as well as with intramucosal adenocarcinoma. Analysis of the data available in the literature reveals that Crohn's disease of the esophagus, although rare, clearly possesses some definite characteristics of its own. It is suggested that the presence of these three features in a single patient constitutes no more than a chance coexistence.

Many specialists and general physicians remain unaware of the potential for and pathogenesis of drug-induced esophageal ulcerations. To promote a greater awareness of the importance of this problem, we have reviewed the literature, particularly in regard to the mechanisms of action and the clinical and therapeutic implications of these chemical injuries to the esophagus. There can be no doubt that the frequency of occurrence of drug-induced esophageal ulceration far exceeds that reflected in the reported cases appearing in the medical literature. Nor can we deny that much of the responsibility for this situation lies in the failure of the prescribing physician to educate his patients (and himself!)in the art of taking potentially harmful pills and capsules, particularly tetracycline, doxycycline, potassium chloride, and quinidine preparations. Although most such drug injuries are self-limited events, there have been a number of fatalities reported and at the very least they involve acute discomfort.

Complete transection of the common bile duct is an unusual complication of elective cholecystectomy. We present a case in which the diagnosis of this rare complication was made postoperatively by endoscopic retrograde cholangiography.

The frequency of HLA antigens was studied in 60 Israeli Jewish patients with ulcerative colitis (UC) and in 18 with Crohn's disease (CD), and it was compared to that in healthy, ethnically-matched controls. From this study it would appear that HLA-BW 35 is highly associated with UC in Israeli Jewish patients and that HLA-AW 24 is present at a high frequency in the "early onset" group and also in the group with "severe" disease, which was composed mainly of female patients. In the CD group, the frequency of the HLA antigens did not differ significantly from that in the control group.

Annals of the New York Academy of SciencesVolume 150, Issue 1 p. 67-74 THE INFLUENCE OF FOOD COMPOSITION ON THE RETENTION OF GAS IN THE STOMACH* Edwin Polish, Edwin Polish Section of Gastroenterology, Hahnemann Medical College and Hospital, Philadelphia, Pa.Search for more papers by this authorUri Kadish, Uri Kadish Section of Gastroenterology, Hahnemann Medical College and Hospital, Philadelphia, Pa.Search for more papers by this author Edwin Polish, Edwin Polish Section of Gastroenterology, Hahnemann Medical College and Hospital, Philadelphia, Pa.Search for more papers by this authorUri Kadish, Uri Kadish Section of Gastroenterology, Hahnemann Medical College and Hospital, Philadelphia, Pa.Search for more papers by this author First published: February 1968 https://doi.org/10.1111/j.1749-6632.1968.tb19032.xCitations: 1 * Supported in part by grants from the Stuart Co., Inc., Pasadena, Calif., and the Thelma Frank Fund. AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume150, Issue1Gastrointestinal GasFebruary 1968Pages 67-74 RelatedInformation