DOI: https://dx.doi.org/10.18203/2349-2902.isj20214770
Published: 2021-11-26

A rare case of idiopathic multiple small bowel strictures in Indian subcontinent: a case report

Garima Dwivedi, Sanjeev Kumar Singla, Rohit Virmani

Abstract


Small bowel ulcers and strictures are uncommon but when they occur they can be an important cause of morbidity. We reported a case of a multiple strictures in small bowel that was treated surgically pain for 15 years. She also had hypoalbuminemia and iron deficiency anemia. A diagnosis of small bowel stricture was made on CT and surgery was advised. Resection of the 100 cm long segment of small bowel was done. Approximately 10 smooth strictures were identified in the resected segment. Histology did not identify any specific cause. A 43 year old Indian female was diagnosed with subacute small bowel obstruction. She had a history of chronic abdominal pain for 15 years. She also had hypoalbuminemia and iron deficiency anemia. A diagnosis of small bowel stricture was made on CT and surgery was advised. Resection of the 100 cm long segment of small bowel was done. Approximately 10 smooth strictures were identified in the resected segment. Histology did not identify any specific cause. Subacute small bowel obstruction can be associated with various factors. Multiple idiopathic small bowel strictures can be considered as one of the causes. In present case no cause of ulcers and strictures could be found. Idiopathic multiple bowel strictures with fecalith is rare. Histopathology and other investigations revealed no specific cause. We recorded no postoperative complications 2 months after surgery by resection and anastomosis.

 


Keywords


Idiopathic small bowel stricture, Multiple fecaliths, Indian subcontinent

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References


Kohoutová D, Bártová J, Tachecí I, Rejchrt S, Repák R, Kopáčová M, et al. Cryptogenic multifocal 6ulcerous stenosing enteritis: a review of the literature. Gastroenterol Res Pract. 2013;2013:918031.

Lang J, Price AB, Levi AJ, Burke M, Gumpel JM, Bjarnason I. Diaphragm disease: pathology of disease of the small intestine induced by non-steroidal anti-inflammatory drugs. J Clin Pathol. 1988;41(5):516-26.

Raskin JB, Pina V. Nonspecific enteric ulcers and strictures. In: Bockus H, Berk JE, eds. Gastroenterology. 4th ed. Philadelphia: Saunders; 1985: 1268-73.

Chung SH, Park SU, Cheon JH, Kim ER, Byeon J, Ye BD, et al. Clinical characteristic and treatment outcomes of cryptogenic multifocal ulcerous stenosing enteritis in Korea. Dig Dis Sci. 2015;60(9):2740-5.

Esaki M, Umeno J, Kitazono T, Matsumoto T. Clinicopathologic features of chronic nonspecific multiple ulcers of small intestine. Clin J Gastroenterol. 2015;8(2):57-62.

Perlemuter G, Guillevin L, Legman P, Weiss L, Couturier D, Chaussade S. Cryptogenic multifocal ulcerous stenosing enteritis: an atypical type of vasculitis or a disease mimicking vasculitis. Gut. 2001;48(3):333-8.

Matsumoto T, Iida M, Matsui T, Yao T. Chronic nonspecific multiple ulcers of the small intestine: a proposal of the entity from Japanese gastroenterologists to Western enteroscopists. Gastrointest Endosc. 2007;66(3):99-107.

Slesser AAP, Wharton R, Smith GV, Buchanan GN. Systematic review of small bowel diaphragm disease requiring surgery. Colorectal Dis. 2012;14(7):804-13.

Velchuru VR, Rimal D, Studley JGN, Sturzaker HG. Diaphragm disease of the ileum. Int J Surg. 2006;4(3):184-6.

Manetas M, O’Loughlin C, Kelemen K, Barkin JS. Multiple small-bowel diaphragms: a cause of obscure GI bleeding diagnosed by capsule endoscopy. Gastrointest Endosc. 2004;60(5):848-51.

Wang ML, Miao F, Tang YH, Zhao XS, Zhong J, Yuan F. Special diaphragm-like strictures of small bowel unrelated to non-steroidal anti-inflammatory drugs. World J Gastroenterol. 2011;17(31):3596-604.

Debray C, Besançon F, Hardouin JP, Martin E, Marche C, Khoury K. Entérite sténosante ulcéreuse plurifocale cryptogénétique. Arch Fr Mal App Dig. 1964;53:193-206.

Chagnon JP, Devars JF, Marche C, Vissuzaine C, Cerf M. Cryptogenetic multifocal ulcerous stenosing enteritis. Gastroenterol Clin Biol. 1984;98(3):808-13.

Doutre LP, Paccalin J, Périssat J, Traissac FJ. Entérite sténosante et ulcéreuse plurifocale (une nouvelle observation). Arch Fr Mal App Dig. 1966;55:537-40.

Raskin JB, Pina V. Nonspecific enteric ulcers and strictures. In: Bockus H, Berk JE, eds. Gastroenterology. 4th ed. Philadelphia: Saunders; 1985: 1268-73.

Chornet JC, Ximénez EG, Company RA, Gonza´ JCC, Aracil JS, Quintana NU, et al. Etude photopléthysmographique de la circulation pariétale du tube digestif en conditions basales et de distension. Travail expérimental chez le chien Lyon Chir. 1988;84:247-51.