Postbulbar duodenal ulceration and stenosis associated with celiac disease

Schweiger, Gary D.; Murray, Joseph A.

doi:10.1007/s002619900358

Cited by 21 publications

(13 citation statements)

References 9 publications

(13 reference statements)

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“…Ulceration in the small intestine may be related to celiac disease, sometimes with intestinal lymphoma (15,16). Strictures have also been associated with celiac disease, particularly in the duodenum (17,18). Drug-induced strictures and diaphragm-like changes have been reported with a number of medications, including potassium chloride, ASA and other nonsteroidal antiinflammatory medications.…”

Section: Discussionmentioning

confidence: 99%

Nonceliac Diaphragm Disease of the Duodenum

Freeman

2000

Canadian Journal of Gastroenterology

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A 58-year-old, Indo-Canadian man presented with upper abdominal pain and the clinical features of a partial, gastric outlet obstruction. Subsequent studies, including endoscopic examination, revealed diaphragm-like strictures in the descending duodenum. Other reported causes such as celiac disease and drug-induced small bowel diaphragms were excluded. Possibly, the changes seen in this patient were related to ethnic food-induced, mucosal injury to the upper gastrointestinal tract. Further studies are needed to evaluate potential toxicity or protective effects of different ethnic diets and their relationship with the development of different intestinal diseases.

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Section: Discussionmentioning

confidence: 99%

Nonceliac Diaphragm Disease of the Duodenum

Freeman

2000

Canadian Journal of Gastroenterology

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“…The causes of duodenal stricture or obstruction are listed in Table 5. [12][13][14][15][16][17][18][19][20][21] Congenital causes of duodenal narrowing can be ruled out by the results of extensive evaluations that the patient had previously undergone. The ultrasonographic studies, CT scans, and endoscopic retrograde cholangiopancreatographic examinations should have identified conditions such as annular pancreas, duodenal webs, or duodenal duplications.…”

Section: Duodenal Stricturementioning

confidence: 99%

“…Perhaps, but the 10-year period of inflammatory bowel disease would probably have made that diagnosis clear. In rare cases, celiac sprue can cause duodenal stenosis, 13 and celiac disease is associated with primary sclerosing cholangitis. However, stenosis associated with celiac disease occurs in the presence of duodenal ulceration, 13 and ulcers were not documented in this case.…”

Section: Duodenal Stricturementioning

confidence: 99%

Case 11-2003

Ross¹,

Anupindi²,

Balis³

2003

N Engl J Med

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case records of the massachusetts general hospitalThe new england journal of medicine n engl j med 348;15 www.nejm.A 14-year-old boy with a history of ulcerative colitis was admitted to the hospital because of vomiting and abdominal pain.Ulcerative colitis had been diagnosed at the age of three years by colonoscopic examination after a barium-enema examination had revealed no abnormalities. In subsequent years, progression of the disease was well controlled with the administration of mesalamine and short courses of an adrenocorticosteroid medication for flares; hospital admission was not required. The patient lived with his parents, two siblings, and a healthy dog. There was no family history of gastrointestinal or autoimmune diseases. first admissionFourteen months before the current admission, abdominal pain, pruritus, and jaundice developed, and the patient was admitted to the hospital. An endoscopic retrograde cholangiopancreatographic study revealed evidence of primary sclerosing cholangitis with a dominant stricture, for which a stent was placed. Cytologic examination of biliary brush specimens disclosed bile-duct epithelium with reactive changes and no malignant cells. The procedure was complicated by pancreatitis. The results of laboratory tests are shown in Table 1. During a five-day hospital stay, the patient received morphine and prednisone, and his condition improved. He was discharged on the sixth hospital day. second admissionFourteen weeks after discharge, the patient was admitted for the second time because of abdominal pain. Another endoscopic retrograde cholangiopancreatographic study was performed, with replacement of the old stent and a sphincterotomy. Examination of a core needle-biopsy specimen of the liver showed changes consistent with the presence of chronic active hepatitis. Antibiotics and hydrocortisone were given, but the next day epigastric and right-upper-quadrant pain developed, and the temperature spiked to 39.8°C. Two blood cultures were sterile, and the amylase and lipase levels remained normal. A chest radiograph showed only a linear opacity, consistent with atelectasis, in the left upper lobe. An abdominal ultrasonographic examination yielded no evidence of bileduct distention or leakage, and the hepatic parenchyma appeared normal; the pancreatic presentation of case The New England Journal of Medicine Downloaded from nejm.org on August 14, 2015. For personal use only. No other uses without permission.

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“…Similar ®ndings in children with coeliac disease have been reported elsewhere, in addition to radiological evidence of post-bulbar duodenal stenosis. 100,101 Acute severe haemorrhage from gastric ulceration has been reported in an adult. 102 …”

Section: Coeliac Diseasementioning

confidence: 99%