Endoscopic Features of Chronic Nonspecific Multiple Ulcers of the Small Intestine: Comparison with Nonsteroidal Anti-inflammatory Drug-Induced Enteropathy

Matsumoto, Takayuki; Nakamura, Shotaro; Esaki, Motohiro; Yada, Shinichiro; Kawanishi, Hideki; Yao, Takashi; Iida, Mitsuo

doi:10.1007/s10620-006-9080-x

Cited by 55 publications

(43 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The sensitivity allowed for the detection of small intestinal lesions, such as red spots, erosions, ulcers, and ulcer scars (1). In addition, another observational study suggested that small intestinal ulcers in NSAID-induced enteropathy occurred in multiplicity either simultaneously or metachronously and improved rapidly after drug discontinuation (15). In the present case, capsule endoscopy showed mild stenosis with multiple ulcerative scars in the small intestine, in addition to erosion.…”

Section: Discussionsupporting

confidence: 51%

Multiple Colon Ulcers with Typical Small Intestinal Lesions Induced by Non-Steroidal Anti-Inflammatory Drugs

et al. 2015

View full text Add to dashboard Cite

The diagnosis of NSAID-induced colon ulcers is difficult when the distribution or endoscopic findings are not typical. An 83-year-old woman was transferred to our hospital for hemorrhagic diarrhea. Colonoscopy showed multiple ulcers in the entire colon, particularly longitudinal ulcers in the transverse colon. These were unusual for NSAID-induced colopathy, although she had been on meloxicam. However, capsule endoscopy revealed multiple scars and erosions, characteristic of NSAIDs users. The final diagnosis was NSAIDinduced enteropathy, and all lesions were in remission after meloxicam discontinuation. We herein emphasize the value of an endoscopic assessment of the entire digestive tract in the diagnosis of NSAID-induced mucosal lesions.

show abstract

Section: Discussionsupporting

confidence: 51%

Multiple Colon Ulcers with Typical Small Intestinal Lesions Induced by Non-Steroidal Anti-Inflammatory Drugs

et al. 2015

View full text Add to dashboard Cite

show abstract

“…In differential diagnosis of CMUSE, first of all Crohn's disease (9,15), NSAIDs-induced enteropathy (9,35), tuberculosis and other infections of the small bowel (8,9,20), Behcet disease (19,21,24) and malignancies must be excluded. It is a well-known fact, that the majority of extranodal malignant lymphoma involves the gastrointestinal tract.…”

Section: Discussionmentioning

confidence: 99%

Severe Cryptogenic Multifocal Ulcerous Stenosing Enteritis. A Report of Three Cases and Review of the Literature

Kohoutová

Bureš

Tyčová

et al. 2010

Acta Med. (Hradec Kralove, Czech Repub.)

View full text Add to dashboard Cite

IntroductionCryptogenic multifocal ulcerous stenosing enteritis (CMUSE) is a rare condition characterised by chronic or relapsing moderate ileous episodes resulting from multiple small intestinal strictures, multiple shallow ulcers of the small bowel and beneficial therapeutical effect of glucocorticosteroids (1, 2). Japanese gastroenterologists call this syndrome chronic non-specific multiple ulcers of the small intestine (CNSU) (3). The aetiology of CMUSE has not been clarified yet and pathogenesis is still poorly understood. Some authors even doubt the real existence of this entity.Patients with CMUSE are often referred for surgery because of symptomatic small intestinal strictures and several resections of the small bowel had to be performed.We report three cases of CMUSE diagnosed within the past 10 years at a single tertiary centre, where more than eight thousand GI endoscopies are performed per year. Review of available relevant literature is provided. Case reports Case 1A 35-year-old woman was admitted to our department because of chronic diarrhoea, colicky abdominal pain, weight loss (16 kg during previous five years) and repeated moderate ileous episodes. She was cachectic (body-mass index 12.8 kg/m 2 ). Laboratory tests showed iron-deficiency anaemia (haemoglobin 96 g/L), thrombocytosis (459.10 9 g/L) and proteino-energy malnutrition (serum prealbumin 0.17 g/L). Abdominal ultrasound revealed strenuous small intestinal peristalsis and a large volume of fluid in the intestinal loops. Enteroclysis provided no further information. Gastroscopy and colonoscopy were normal. Push-enteroscopy found multiple shallow ulcers of the distal duodenum and proximal jejunum ( Fig. 1) and increased stagnant fluid content in the proximal part of the small bowel. A non-specific inflammatory process was detected at histology and electron microscopy of small intestinal biopsy specimens. Coeliac disease, lymphoma, Crohn's disease and vasculitis were excluded. No infective agent was found. Total parenteral nutrition and glucocorticosteroids improved her general condition including nutritional status (serum albumin 35.8 g/L, prealbumin 0.29 g/L, body-mass index 13.4 kg/m 2 ). The patient was discharged on enteral nutrition, glucocorticosteroids (prednisone was gradually replaced by budesonide) and 5-aminosalicylates. She was followed-up at regular controls. Nine months later the patient had to be admitted because of a worsened general condition (frequent watery stools, fatigue, oedemas of lower extremities, fluidothorax and ascites). Laboratory tests revealed hypo-25 CASE REPORT Summary: Cryptogenic multifocal ulcerous stenosing enteritis (CMUSE) is a rare condition characterised by chronic or relapsing moderate ileous episodes resulting from multiple small intestinal strictures, multiple shallow ulcers of the small bowel and favourable therapeutical effect of glucocorticosteroids. The aim of this paper was to evaluate three cases of CMUSE diagnosed within 10 years at a tertiary gastroenterology centre. Three females (35, 50, ...

show abstract

“…We have previously reported on an unusual form of enteropathy of unknown etiology, referred to as chronic nonspecific multiple ulcers of the small intestine (CNSU), which is characterized by chronic blood and protein loss through persistent small intestinal ulcers [4][5][6]. Although this rare but distinct clinicopathologic condition was initially reported in the Japanese literature by Okabe and Sakimura [7], the term ''nonspecific'' in its nomenclature which refers to the nonspecific histology of the ulcers has occasionally led to the misinterpretation of the disease as any condition with small intestinal ulcers of undetermined etiology.…”

Section: Introductionmentioning

confidence: 99%

Clinicopathologic features of chronic nonspecific multiple ulcers of the small intestine

Esaki

Umeno

Kitazono

et al. 2015

Clin J Gastroenterol

Self Cite

View full text Add to dashboard Cite

show abstract

Endoscopic Features of Chronic Nonspecific Multiple Ulcers of the Small Intestine: Comparison with Nonsteroidal Anti-inflammatory Drug-Induced Enteropathy

Cited by 55 publications

References 26 publications

Multiple Colon Ulcers with Typical Small Intestinal Lesions Induced by Non-Steroidal Anti-Inflammatory Drugs

Multiple Colon Ulcers with Typical Small Intestinal Lesions Induced by Non-Steroidal Anti-Inflammatory Drugs

Severe Cryptogenic Multifocal Ulcerous Stenosing Enteritis. A Report of Three Cases and Review of the Literature

Clinicopathologic features of chronic nonspecific multiple ulcers of the small intestine

Contact Info

Product

Resources

About