title: Severe cryptogenic multifocal ulcerous stenosing enteritis. A report of three cases and review of the literature.
abstract: 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, 60 years) were presented with colicky pain, repeated moderate ileous episodes and weight loss. Multiple fibrous strictures and ulcers of the small bowel were found. All three patients responded to glucocorticosteroid treatment. Tandem tight jejunal stenoses were dilated endoscopically by means of double balloon enteroscopy. In conclusion, CMUSE should always be considered when chronic moderate ileous episodes and multiple small intestinal strictures and ulcers of uncertain aetiology are found. Double balloon enteroscopy enables precise diagnostic work, possible endoscopic treatment of stenoses, may obviate the need for surgery and prevent excessive small bowel resections.
authors.affiliation: Charles University in Prague, Faculty of Medicine and 2nd Department of Internal Medicine, Division of Gastroenterology, University Hospital Hradec Králové, Czech Republic. darina.kohoutova@seznam.cz
authors.forename: Darina
authors.initials: D
authors.lastname: Kohoutová
authors.forename: Jan
authors.initials: J
authors.lastname: Bures
authors.forename: Vera
authors.initials: V
authors.lastname: Tycová
authors.forename: Jolana
authors.initials: J
authors.lastname: Bártová
authors.forename: Ilja
authors.initials: I
authors.lastname: Tachecí
authors.forename: Stanislav
authors.initials: S
authors.lastname: Rejchrt
authors.forename: Zdenek
authors.initials: Z
authors.lastname: Vacek
authors.forename: Rudolf
authors.initials: R
authors.lastname: Repák
authors.forename: Marcela
authors.initials: M
authors.lastname: Kopácová
mesh_terms: D000328:Adult; D004751:Enteritis / Q000150:complications* / Q000473:pathology; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000150:complications* / Q000473:pathology; D007421:Intestine, Small / Q000473:pathology; D008875:Middle Aged; D014456:Ulcer / Q000150:complications* / Q000473:pathology