{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T12:09:38Z","timestamp":1785326978438,"version":"3.55.0"},"reference-count":47,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":26,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81860102"],"award-info":[{"award-number":["81860102"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82060102"],"award-info":[{"award-number":["82060102"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Immunity Inflam &amp;amp; Disease"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Upper gastrointestinal Crohn's disease (UGI\u2010CD) is rare, with an adult prevalence of 0.5%\u20134.0%. Its nonspecific symptomatology and the absence of clear diagnostic guidelines pose significant diagnostic challenges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>We present two patients with UGI\u2010CD treated at Hainan General Hospital. In the first case, a 47\u2010month diagnostic delay led to disease progression and surgical intervention. In the second case, prompt diagnosis of a duodenal ulcer enabled medical management, avoiding surgery. Both patients received infliximab and achieved remission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      These cases highlight diagnostic challenges in UGI\u2010CD and offer three key lessons: (i) UGI\u2010CD should be suspected in refractory,\n                      <jats:italic>Helicobacter pylori<\/jats:italic>\n                      \u2010negative duodenal ulcers; (ii) an endoscopic\u2010radiologic mismatch may occur; and (iii) we propose a diagnostic algorithm to assist early recognition, though it has not been prospectively validated. Given the descriptive nature of this two\u2010case series, these findings are hypothesis\u2010generating and require further validation.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/iid3.70491","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T09:10:09Z","timestamp":1785143409000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Diagnostic Challenge of Crohn's Disease With Initial Duodenal Involvement: Two Cases and Literature Review"],"prefix":"10.1002","volume":"14","author":[{"given":"Chaochao","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Hainan General Hospital Hainan Affiliated Hospital of Hainan Medical University  Haikou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3462-0706","authenticated-orcid":false,"given":"Yongrong","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hainan General Hospital Hainan Affiliated Hospital of Hainan Medical University  Haikou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiyao","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hainan General Hospital Hainan Affiliated Hospital of Hainan Medical University  Haikou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhoutao","family":"He","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hainan General Hospital Hainan Affiliated Hospital of Hainan Medical University  Haikou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng","family":"Lan","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hainan General Hospital Hainan Affiliated Hospital of Hainan Medical University  Haikou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41575-023-00871-3"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2019.04.040"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.immuni.2023.01.002"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6109(05)70276-0"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.5217\/ir.2019.00091"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/ibd\/izx083"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v3.i6.479"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12328-017-0759-7"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1155\/2019\/2708909"},{"key":"e_1_2_11_11_1","first-page":"881","article-title":"Regional Jejunitis","volume":"38","author":"Gottlieb C.","year":"1937","journal-title":"American Journal of Roentgenology"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjy121"},{"issue":"25","key":"e_1_2_11_13_1","first-page":"00416","article-title":"Diagnosis and Management of Upper Gastrointestinal Involvement in Adult Patients With Crohn's Disease: A Systematic Review","volume":"1542","author":"Cohen N. 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