Kim Hyung Hun, Kim You Sun, Ok Kyung Sun, Ryu Soo Hyung, Lee Jung Hwan, Moon Jeong Seop, Lee Hyuck Sang, Lee Hye Kyung
Departments of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea.
Korean J Gastroenterol. 2010 Dec;56(6):382-6. doi: 10.4166/kjg.2010.56.6.382.
Chronic non-granulomatous jejunoileitis is a rare disease characterized by malabsorption, abdominal pain, and diarrhea that causes shallow ulcers in the small bowel. The etiology of chronic non-granulomatous jejunolieitis remains unknown. A 69-year-old man complained of abdominal pain and lower extremity edema. A 99m-Tc albumin scan showed increased radioactivity at the left upper quadrant, suggesting protein-losing enteropathy. A small bowel follow-through did not disclose any lesions. Wireless capsule endoscopy revealed several small bowel ulcers and strictures. A jejunoileal segmentectomy with end-to-end anastomosis was performed, and the histologic examination revealed non-granulomatous ulcers with focal villous atrophy. Ruling out all other possible diagnoses, we diagnosed our patient with chronic non-granulomatous ulcerative jejunoileitis. Postoperatively, the patient's abdominal pain and lower extremity edema improved, and the serum albumin normalized. This is the first case of chronic non-granulomatous ulcerative jejunoileitis localized by wireless capsule endoscopy and treated successfully with segment resection.
慢性非肉芽肿性空回肠炎是一种罕见疾病,其特征为吸收不良、腹痛和腹泻,并在小肠形成浅表溃疡。慢性非肉芽肿性空回肠炎的病因尚不清楚。一名69岁男性主诉腹痛和下肢水肿。锝-99m白蛋白扫描显示左上腹放射性增强,提示蛋白丢失性肠病。小肠钡剂造影未发现任何病变。无线胶囊内镜检查发现多处小肠溃疡和狭窄。行空回肠段切除术并端端吻合,组织学检查显示为非肉芽肿性溃疡伴局灶性绒毛萎缩。排除所有其他可能的诊断后,我们诊断该患者为慢性非肉芽肿性溃疡性空回肠炎。术后,患者的腹痛和下肢水肿得到改善,血清白蛋白恢复正常。这是首例通过无线胶囊内镜定位并经节段性切除成功治疗的慢性非肉芽肿性溃疡性空回肠炎病例。