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Recurrent small bowel obstruction as a rare presentation of undiagnosed sarcoidosis
  1. Ashton A Naumann,
  2. Vanessa I Rodriguez and
  3. Andrew Shychuk
  1. Medicine, University of Florida, Gainesville, Florida, USA
  1. Correspondence to Ashton A Naumann; ashton.naumann{at}ufl.edu

Abstract

Sarcoidosis is an immune-mediated inflammatory disorder with unknown aetiology that is marked by non-caseating granulomas in affected organs. Pulmonary sarcoidosis is the most common manifestation, but gastrointestinal involvement, particularly in the small bowel, is exceedingly rare. While symptom-driven treatment guidelines that are steroid based are well established for pulmonary and few extrapulmonary manifestations (ie, cardiac, neurologic, renal), gastrointestinal sarcoidosis treatment is largely extrapolation with optimal management under investigation. Additionally, few works document small bowel obstruction related to small bowel sarcoidosis. We present a case of short-interval recurrent small bowel obstruction in a man in his sixties that revealed newly diagnosed sarcoidosis with suspected small bowel involvement who never underwent steroid therapy. The patient exhibited gastrointestinal symptoms, despite asymptomatic pulmonary disease and a course of prednisone may have reduced his risk of recurrence. We also review suggested gastrointestinal sarcoidosis treatment and surveillance guidelines with focus on the small bowel.

  • Small intestine
  • Immunology
  • Medical management
  • Dermatology

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Footnotes

  • Contributors AAN, VIR and AS jointly conceived of the idea for the case report. AAN was primarily responsible for writing the manuscript. VIR helped with background research and assisted with writing the manuscript. AS assisted with writing the manuscript, provided subject matter expertise, and is responsible for its final content.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.