| Objective: To report a case of cryptogenic multifocal ulcerating stenosing enteritis(CMUSE),and to improve clinicians' cognition of this rare disease,early diagnosis and treatment should be achieved to delay disease progression and avoid surgical operations.Methods: The clinical characteristics,laboratory examination,imaging examination,endoscopic findings,histopathological features and treatment of the patient with CMUSE from our Hospital were collected.Results: Male,22 years old,was admitted to hospital with the main cause of "intermittent black stool for more than 5 years,aggravated with double lower limb edema for 4 days".Patients with repeated black stool,abdominal pain and other symptoms."Iron deficiency anemia" and "incomplete intestinal obstruction" were used for treatment,with poor results and repeated symptoms.Laboratory examination of the patient indicated small cell hypochromic anemia,hypoalbuminemia,normal inflammatory indicators such as erythrocyte sedimentation.Gastroscopy and colonoscopy showed no obvious abnormality.Abdominal CT showed obvious annular thickening of intestinal wall and intestinal stenosis.Double-balloon enteroscopy revealed multiple ulcers in the small intestine.Histopathology revealed chronic mucosal inflammation with focal inflammatory exudation.CMUSE and Crohn's disease(CD)were suspected.Prednisone acetate oral administration,clinical symptoms gradually relieved.A few months later,he was re-admitted to the hospital for re-examination of the small intestine.Finally,CMUSE was suspected.Conclusion: CMUSE should be considered in patients with unexplained recurrent black stools,anemia,multiple small intestinal ulcers,and stenosis.Double-balloon enteroscopy is of high diagnostic value for this disease.At present,there is no specific treatment,glucocorticoid therapy is effective,easy to produce hormone dependence.Endoscopic and surgical treatment can relieve symptoms,but recurrent attacks. |
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