You are here

Article Text

Article menu
Images in...
Small-bowel ulcerations at wireless capsule endoscopy: go the whole way
Free
  1. F Wartel,
  2. V Maunoury,
  3. P Bulois,
  4. S Papadopoulos,
  5. B Filoche,
  6. J F Colombel
  1. Gastroenterology Department, Hopital Huriez, CHRU, Lille, France
  2. Service d’Anatomie et de Cytologie Pathologique du Groupe Hospitalier de l’Institut Catholique de Lille, Hopital Saint Vincent de Paul, Lille, France
  3. Gastroenterology Department, Hopital St Philibert, Lomme, France
  4. Gastroenterology Department, Hopital Huriez, CHRU, Lille, France
  1. vmaunoury{at}chru-lille.fr

https://doi.org/10.1136/bcr.2006.097733

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    CLINICAL PRESENTATION

    A 22-year-old woman was referred to our hospital for abdominal pain, diarrhoea and weight loss. The patient had no history of surgery or illness. On physical examination, the abdomen was soft and no mass was palpable. Laboratory tests revealed an inflammatory syndrome with increased C reactive protein (36 mg/l) and presence of anti-saccharomyces cerevisiae antibodies at a significant level of 40 units (n<10). No pathological findings were found on upper gastrointestinal endoscopy and colonoscopy with biopsy specimens; small-bowel follow-through was normal. Wireless capsule endoscopy (WCE) of the small bowel revealed ulcerations that were considered as diagnostic for Crohn’s disease (CD) (fig 1).

    Figure 1
    Figure 1 Linear ulceration on wireless capsule endoscopy (WCE).

    The patient was unsuccessfully treated with steroids while azathioprine was started. Three months later, no symptomatic improvement was observed. Two infusions of infliximab were then administered, but abdominal pain persisted. Surgical exploration of the abdomen by laparoscopy displayed no macroscopic features of CD.

    QUESTION:

    What further investigation would you suggest?

    See page 1164 for answer

    This case is submitted by:

    Acknowledgments

    This article has been adapted from Wartel F, Maunoury V, Bulois P, Papadopoulos S, Filoche B, Colombel J F. Small-bowel ulcerations at wireless capsule endoscopy: go the whole way Gut 2007;56:1132