JOURNAL OF CLINICAL SURGERY ›› 2021, Vol. 29 ›› Issue (2): 144-147.doi: 10.3969/j.issn.1005-6483.2021.02.014

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Experience in diagnosis and treatment of cryptogenic multifocal ulcerous stenosing enteritis

  

  • Online:2021-02-20 Published:2021-02-20

Abstract: Objective:To observe the clinical features of patients with cryptogenic multifocal ulcerative ulcerous stenosing enteritis(CMUSE),and to improve the diagnosis and treatment strategy of CMUSE combined with literature review.Methods:The clinical and followup data of 8 patients with CMUSE who received medical and surgical treatment in our center from January 2018 to December 2019 were reviewed retrospectively.The observation indexes included clinical symptoms,laboratory examination,imaging or endoscopy(enteroscopy / capsule endoscopy),pathological examination and therapeutic effect.Results:7 patients were treated by operation and 1 patient was treated conservatively.Laboratory tests showed varying degrees of anemia and occult blood positive,and the average ESR was not significantly abnormal.Abdominal CT/MRI showed that the intestinal wall was thickened obviously.Circular stenosis of intestine could be seen in the surgical treatment group.The time of hormone reduction in the drug treatment group were 1 month,2 months and 4 months after discharge,respectively.The average followup time was 8 months.The conservative treatment patients had no obvious symptoms of abdominal pain,diarrhea and adverse reactions of drug treatment,and the surgical patients had no obvious shortterm complications.Conclusion:The misdiagnosis rate of CMUSE is high,and the clinical significance of endoscopy is more significant than that of inflammation,and the inclusion criteria should be more stringent than other inflammatory bowel diseases.Partial small bowel resection with sidetoside anastomosis is a higher priority for patients with recurrent attacks.

Key words: cryptogenic multifocal ulcerous stenosing enteritis, inflammatory bowel diseases, operation

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