Department of Internal Medicine, Seoul Paik Hospital, Inje University, College of Medicine Seoul, Seoul, South Korea.
J Gastrointestin Liver Dis. 2012 Sep;21(3):309-12.
Cryptogenic multifocal ulcerous stenosing enteritis is a rare idiopathic disease of the small bowel. Its origin and pathophysiology have not been established. Clinicopathologic features include unexplained small bowel strictures with superficial ulceration, chronic or relapsing occlusion episodes. A 44-year-old man complained of recurrent colicky abdominal pain and dizziness. Laboratory tests indicated iron-deficiency anemia. There was no evidence of bleeding on esophagogastroduodenoscopic and colonofiberscopic examination. With capsule endoscopy, multiple mucosal ulcers were visualized in the jejunoileal area. A small-bowel series revealed severe strictures and the capsule was retained in the stenotic focus without obstructive symptoms. Small bowel segmental resection with end-to-end anastomosis was performed, and the histologic examination indicated cryptogenic multifocal ulcerous stenosing enteritis. After surgery, the patient's symptoms were completely resolved and his anemia was corrected. Cryptogenic multifocal ulcerous stenosing enteritis should be considered in cases of chronic or recurrent occlusion events and multiple small intestinal ulcers and strictures of unknown origin.
不明原因多灶性溃疡性狭窄性肠炎是一种罕见的小肠特发性疾病。其病因和病理生理学尚未确定。临床病理特征包括原因不明的小肠狭窄伴浅表溃疡、慢性或复发性闭塞发作。一名 44 岁男性因反复发作性绞痛性腹痛和头晕而就诊。实验室检查提示缺铁性贫血。上消化道内镜和结肠镜检查均未见出血证据。胶囊内镜检查显示空肠回肠区域有多处黏膜溃疡。小肠造影检查显示严重狭窄，胶囊在狭窄部位滞留，无梗阻症状。行小肠节段性切除端端吻合术，组织学检查提示不明原因多灶性溃疡性狭窄性肠炎。术后患者症状完全缓解，贫血得到纠正。对于慢性或复发性闭塞事件以及多个原因不明的小肠溃疡和狭窄，应考虑不明原因多灶性溃疡性狭窄性肠炎。
