Free perforation of the small intestine in collagenous sprue

Figure 1 Antemortem biopsy from duodenum showed features of untreated celiac disease, despite a gluten-free diet. Although later postmortem PCRof this biopsy documented a monoclonal population of T cells, frank lymphoma was not detected.

Figure 2 Postmortem small bowel section showed diffuse mucosal involvement with collagenous sprue. Note eosin-stained sub-epithelial band. Trichrome staining was also positive (HE, × 20).

Figure 3 Autopsy showed ileum with a focal jejunal ulcer and perforation. A: Low-power photomicrograph showed jejunal ulceration with perforation in an area of collagenous sprue in postmortem material; B: High-power photomicrograph showed perforated collagenous sprue.