Albahli Meshael S, Aljarallah Fares Ali M, Alshaya Ali K, Alabdulaaly Nourah, Altoukhi Khaled, Alshurafa Haider A
General Surgery, Prince Sultan Military Medical City, Riyadh, SAU.
General Surgery, King Khalid University, Riyadh, SAU.
Cureus. 2025 Feb 7;17(2):e78692. doi: 10.7759/cureus.78692. eCollection 2025 Feb.
Enteritis cystica profunda (ECP) is a rare benign condition characterized by mucin-filled cystic spaces in the submucosal layer of the small intestine. It is often associated with inflammatory conditions, such as Crohn's disease. This case report describes a 47-year-old male with a history of diabetes and hypertension who presented with flank pain and dysuria. Imaging revealed a mesenteric mass, which led to a differential diagnosis that included malignancies. Despite extensive evaluations, including computed tomography (CT) scans, positron emission tomography (PET) scans, and colonoscopies, the mass showed no significant changes over time. Six months after the initial presentation, the patient returned with acute abdominal pain and signs of bowel obstruction. Surgical intervention revealed a cauliflower-shaped mass at the root of the mesentery, necessitating resection of the small bowel and cecum. Histopathological analysis confirmed ECP. Postoperatively, the patient developed abdominal collections but responded well to treatment, including antibiotics and interventional radiology. This case underscores the diagnostic challenges of ECP, particularly its potential to mimic malignancies, complicating its management in patients with underlying gastrointestinal (GI) diseases. Enhanced awareness and understanding of ECP are crucial for timely diagnosis and appropriate surgical intervention to prevent complications. Continued research is necessary to refine management strategies for this rare condition.
深部囊性肠炎(ECP)是一种罕见的良性疾病,其特征是小肠黏膜下层出现充满黏液的囊性间隙。它常与炎症性疾病相关,如克罗恩病。本病例报告描述了一名47岁男性,有糖尿病和高血压病史,出现胁腹痛和排尿困难。影像学检查发现肠系膜肿块,这导致了包括恶性肿瘤在内的鉴别诊断。尽管进行了广泛评估,包括计算机断层扫描(CT)、正电子发射断层扫描(PET)和结肠镜检查,但肿块随时间推移无明显变化。初次就诊6个月后,患者因急性腹痛和肠梗阻症状再次就诊。手术干预发现肠系膜根部有一个菜花状肿块,需要切除小肠和盲肠。组织病理学分析证实为ECP。术后,患者出现腹腔积液,但对抗生素和介入放射学等治疗反应良好。本病例强调了ECP的诊断挑战,尤其是其可能酷似恶性肿瘤,使患有潜在胃肠(GI)疾病患者的管理复杂化。提高对ECP的认识和理解对于及时诊断和采取适当的手术干预以预防并发症至关重要。持续研究对于完善这种罕见疾病的管理策略是必要的。