Observation
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Oct 21, 2009; 15(39): 4883-4885
Published online Oct 21, 2009. doi: 10.3748/wjg.15.4883
Multifocal stenosing ulceration of the small intestine
Hugh James Freeman
Hugh James Freeman, Department of Medicine, University of British Columbia, UBC Hospital, 2211 Wesbrook Mall, Vancouver, BC V6T 1W5, Canada
Author contributions: Freeman HJ wrote the entire paper.
Correspondence to: Dr. Hugh James Freeman, MD, FRCPC, FACP, Department of Medicine, University of British Columbia, UBC Hospital, 2211 Wesbrook Mall, Vancouver, BC V6T 1W5, Canada. hugfree@shaw.ca
Telephone: +1-604-8227216 Fax: +1-604-8227236
Received: May 27, 2009
Revised: September 14, 2009
Accepted: September 21, 2009
Published online: October 21, 2009
Abstract

Several reports have described an apparently uncommon clinicopathological disorder that is characterized by multifocal stenosing small-intestinal ulceration. Compared to Crohn’s disease, the ulcers are not transmural and typically remain shallow, and involve only the mucosa and submucosa. The disorder seems to be localized in the jejunum and proximal ileum only, and not the distal ileum or colon. Only nonspecific inflammatory changes are present without giant cells or other typical features of granulomatous inflammation. Most patients present clinically with recurrent obstructive events that usually respond to steroids, surgical resection, or both. With the development of newer imaging modalities to visualize the small-intestinal mucosa, such as double-balloon enteroscopy, improved understanding of the long-term natural history of this apparently distinctive disorder should emerge.

Keywords: Ulcer, Stenosis, Intestinal diseases, Small intestine, Crohn’s disease