Nasal manifestations of Crohn's disease are quite rare. They are typified by chronic mucosal inflammation, obstruction, bleeding, and occasionally septal perforation—signs and symptoms that are common to many disease states of the nose. Nasal findings, much like oral lesions, can precede the more typical gastroenterologic manifestations of Crohn's disease. Otolaryngologists should be aware of such an association and consider the diagnosis of Crohn's disease in atypical cases of nasal disease. We report the case of a 12-year-old boy who had severe Crohn's disease and a nasal septal perforation, and we discuss this complication in the context of its otolaryngologic manifestations.
References
1.
GreensteinAJ, JanowitzHD, SacharDB. The extra-intestinal complications of Crohn's disease and ulcerative colitis: A study of 700 patients. Medicine (Baltimore)1976; 55:401–12.
2.
CroftCB, WilkinsonAR. Ulceration of the mouth, pharynx, and larynx in Crohn's disease of the intestine. Br J Surg1972; 59:249–52.
3.
PlauthM, JenssH, MeyleJ.Oral manifestations of Crohn's disease. An analysis of 79 cases. J Clin Gastroenterol1991; 13:29–37.
4.
HyamsJS. Extraintestinal manifestations of inflammatory bowel disease in children. J Pediatr Gastroenterol Nutr1994; 19:7–21.
5.
KinnearWJ. Crohn's disease affecting the nasal mucosa. J Otolaryngol1985; 14:399–400.
6.
PochonN, DulguerovP, WidgrenS.Nasal manifestations of Crohn's disease. Otolaryngol Head Neck Surg1995; 113:813–5.
7.
ClearyKR, BatsakisJG. Orofacial granulomatosis and Crohn's disease. Ann Otol Rhinol Laryngol1996; 105:166–7.
8.
GhandourK, IssaM.Oral Crohn's disease with late intestinal manifestations. Oral Surg Oral Med Oral Pathol1991; 72:565–7.
9.
BozkurtT, LangerM, FendelK, LuxG.Granulomatous tonsillitis. A rare extraintestinal manifestation of Crohn's disease. Dig Dis Sci1992; 37:1127–30.
10.
KellyJH, MontgomeryWW, GoodmanML, MulvaneyTJ. Upper airway obstruction associated with regional enteritis. Ann Otol Rhinol Laryngol1979; 88:95–9.
11.
WilderWM, SlagleGW, HandAM, WatkinsWJ. Crohn's disease of the epiglottis, aryepiglottic folds, anus, and rectum. J Clin Gastroenterol1980; 2:87–91.
12.
LamblinC, CopinMC, BillautC, Acute respiratory failure due to tracheobronchial involvement in Crohn's disease. Eur Respir J1996; 9:2176–8.
13.
BasuMK, AsquithP.Oral manifestations of inflammatory bowel disease. Clin Gastroenterol1980; 9:307–21.
14.
KuriloffDB. Nasal septal perforations and nasal obstruction. Otolaryngol Clin North Am1989; 22:333–50.
15.
BaumED, BoudousquieAC, LiS, MirzaN.Sarcoidosis with nasal obstruction and septal perforation. Ear Nose Throat J1998; 77: 896–8, 900–2.
