Early cryptogenic multifocal ulcerous stenosing enteritis:a case report and literature review
10.3969/j.issn.1008-9691.2024.04.018
- VernacularTitle:早期隐源性多灶性溃疡性狭窄性小肠炎病例报告附文献复习
- Author:
Xu LIU
1
;
Chunze ZHANG
;
Lei SHI
;
Xiaopeng ZHONG
;
Yu WU
Author Information
1. 天津医科大学附属南开医院胃肠外科,天津 300102
- Keywords:
Cryptogenic multifocal ulcerous stenosing enteritis;
Gastrointestinal hemorrhage;
Small intestinal ulcer;
Enteroscopy
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2024;31(4):473-477
- CountryChina
- Language:Chinese
-
Abstract:
Objective To report the diagnosis and treatment process of a case of cryptogenic multifocal ulcerous stenosing enteritis(CMUSE)to enhance the understanding of gastrointestinal hemorrhage caused by multiple ulcers in small intestine and provide reference for clinical diagnosis and treatment.Methods A case of early CMUSE admitted to Tianjin Union Medical Center in September 2021 was analyzed based on clinical characteristics,laboratory examinations,imaging examinations,endoscopy examinations,pathological tissues,treatment methods and follow-up results,and the statistical analysis of related literature was conducted.CMUSE was compared with Crohn's disease(CD),non-steroidal anti-inflammatory drug(NSAID)associated enteritis and intestinal tuberculosis,and the treatment principles and clinical experience of CMUSE were summarized.Results The patient,a 54-year-old male,was diagnosed in September 2021 due to"dark red bloody stool for 5 days".Enteroscopy revealed multiple patchy ulcers in the jejunoileum with local white fur,swelling at the edges,partially healed,and circumferential stenosis in some of the intestinal lumen.Histopathological examination showed acute and chronic inflammation of jejunum and ileum mucosa with ulcers and granulation tissue as well as abundant neutrophil infiltrations.The patient was diagnosed with CMUSE after ruling out other small intestine diseases.Treatment with methylprednisolone for 28 days led to significant improvements in imaging and laboratory indicators.A follow-up enteroscopy 2 years later showed no abnormalities,and as of September 2023,there has been no recurrence.Conclusions CMUSE is a rare disease of unknown etiology.CMUSE should be considered in the case of gastrointestinal hemorrhage due to multiple ulcers of small intestine and chronic small intestinal obstruction caused by fibrous stenosis at the ulcer site.Capsule endoscopy and enteroscopy can support the diagnosis,but capsule endoscopy may be entrapped in the stenosis segment,which can lead to intestinal obstruction.Glucocorticoid hormone therapy should be used as soon as possible after diagnosis,and satisfactory results can be achieved.
