Department of Gastroenterology, Cliniques universitaires Saint Luc, Brussels, Belgium.
Department of Radiology, Cliniques universitaires Saint Luc, Brussels, Belgium.
Acta Gastroenterol Belg. 2022 Jul-Sep;85(3):527-530. doi: 10.51821/85.3.9471. Epub 2022 Jun 30.
We present the case of a 59-years-old woman with a history of abdominal pain and iron-deficiency anemia. Upper and lower gastrointestinal endoscopy turned out negative and further investigation with wireless videocapsule showed an inflammatory stricture in the middle of the small bowel with retention of the videocapsule. Treatment with budesonide was initiated and allowed the spontaneous evacuation of the videocapsule. Retrograde motorized spiral enteroscopy was performed and confirmed an ulcerative stricture 60 cm proximal to the ileocaecal valve. Clinical, iconographic, endoscopic and histological results were compatible with a rare entity described as cryptogenic multifocal ulcerative stenosing enteritis (CMUSE). After the diagnosis budesonide was replaced by azathioprine 100 mg/d as an immunosuppressor. However, azathioprine induced mild pancreatitis and a second course of budesonide was started again. Clinical evolution was favorable.
我们报告了一例 59 岁女性，有腹痛和缺铁性贫血病史。上消化道和下消化道内镜检查结果均为阴性，进一步的无线视频胶囊检查显示小肠中段存在炎症性狭窄，并导致胶囊滞留。给予布地奈德治疗后，胶囊自行排出。逆行动力螺旋式结肠镜检查证实回盲瓣近端 60cm 处存在溃疡性狭窄。临床、影像学、内镜和组织学结果与一种罕见实体相符，被描述为隐源性多灶性溃疡性狭窄性肠炎（CMUSE）。诊断明确后，将布地奈德替换为 100mg/d 的巯嘌呤作为免疫抑制剂。然而，巯嘌呤引起了轻度胰腺炎，再次开始使用布地奈德治疗。临床转归良好。
