Ulcerative Jejunoileitis: A Complication of Celiac Sprue Simulating Crohn’s Disease Diagnosed with Capsule Endoscopy (PillCam)

Excerpt

Jejunitis may be caused by bacterial infections, celiac sprue, Crohn’s disease, ischemia, radiation, injury, vasculitis, or toxins. The inflammatory process, regardless of its etiology, may progress from mucosal inflammation alone to involve the deeper bowel layers, resulting in ulcerations and narrowing of the jejunum. Celiac sprue typically affects the proximal small bowel and manifests as a malabsorption syndrome characterized by weight loss, abdominal distention, diarrhea, and steatorrhea [1]. Ulcerative jejunitis, a complication of celiac disease, is characterized by multiple chronic ulcers and scarring leading to stricture formation which may simulate the endoscopic and clinical manifestations of Crohn’s disease, ischemic vasculitis, or jejunal neoplasm [9]. This is the first case report describing the use of wireless capsule enteroscopy (WCE) for diagnosis of ulcerative jejunitis with documentation of healing by endoscopy. In addition, it enforces that diffuse aptheael jejunal ulcerations are part of the spectrum of intestinal findings in patients with celiac disease [5] and documents successful medical therapy for capsule retention. …