Duodenal Crohn’s disease is rare,and patients withoutobstruction are treated medically.We herein report onecase whose duodenal Crohn’s disease was successfullymanaged with low-speed elemental diet infusion througha nasogastric tube.A 28-year-old female developedacute duodenal Crohn’s disease.Upper GI radiologicand endoscopic examinations showed a stricture in theduodenal bulb.Using the duodenal biopsy specimens,mucosal cytokine levels were measured;interleukin(IL)-1β,IL-6,IL-8,and tumor necrosis factor-α levelswere remarkably elevated.For initial 2 wk,powderedmesalazine was orally given but it was not effective.Forthe next 2 wk,she was treated with low-speed elementaldiet therapy using a commercially available Elental~(TM),which was infused continuously through a nasogastrictube using an infusion pump.The tip of the nasogastrictube was placed at an immediate oral side of the pylorus.The infusion speed was 10 mL/h(usual speed,100 mL/h).After the 2-wk treatment,her symptoms were very muchimproved,and endoscopically,the duodenal stricture andinflammation improved.The duodenal mucosal cytokinelevels remarkably decreased compared with those beforethe treatment.Although our experience was limited,low-speed elemental diet infusion through a nasogastric tubemay be a useful treatment for acute duodenal Crohn’sdisease. Duodenal Crohn’s disease is rare, and patients withoutobstruction are treated medically. We herein report one case whose duodenal Crohn’s disease was successfullymanaged with low-speed elemental diet infusion througha nasogastric tube. A 28-year-old female developedacute duodenal Crohn’s disease. Super GI radiologicand endoscopic examining showed a stricture in the duodenal bulb. Using the duodenal biopsy specimens, mucosal cytokine levels were measured; interleukin (IL) -1β, IL-6, IL-8, and tumor necrosis factor-α levelswere remarkably elevated .For initial 2 wk, powderedmesalazine was orally given but it was not effective. Forty next 2 wk, she was treated with low-speed elementaldiet therapy using a commercially available Elental ™ (TM), which was infused continuously through a nasogastrictube using an infusion pump. The tip of the nasogastrictube was placed at an immediate oral side of the pylorus. infusion rate was 10 mL / h (usual speed, 100 mL / h). After the 2-wk treatment, her symptoms were very m uchimproved, and endoscopically, the duodenal stricture andinflammation improved.The duodenal mucosal cytokinelevels remarkably decreased compared with those before the treatment. Although our experience was limited, low-speed elemental diet infusion through a nasogastric tubemay be a useful treatment for acute duodenal Crohn’s disease.