Related Experiment Video
Updated: May 13, 2026

An Intravital Microscopy-Based Approach to Assess Intestinal Permeability and Epithelial Cell Shedding Performance
Published on: December 3, 2020
Cytomegaloviral enteritis: a rare cause of small gut perforation
Maqbool Ahmed1, Sohail Saqib, Mannan Masud
1Department of Surgery, Military Hospital, Rawalpindi, Pakistan. maqbool957@hotmail.com
Abstract:
A 47-year-old man was admitted with four months history of pain upper central abdomen associated with passage of 3-4 loose watery stools per day. Abdominal examination revealed soft abdomen with mild tenderness in the para-umbilical region. There was associated hepatomegaly. His Hb% was low, liver and renal functions were deranged. Upper GI endoscopy revealed antral ulcer, and colonoscopy revealed a caecal ulcer, which were biopsied. Liver biopsy was also done. Histopathology report showed evidence of inflammatory colitis and chronic hepatitis, so a diagnosis of inflammatory bowel disease with autoimmune hepatitis was made. He was negative for HIV and hepatitis serology. He was given long list of medicine including steroids but the symptoms did not improve. Two months after admission he developed severe abdominal pain associated with distension. The X-Ray chest revealed pneumoperitoneum and laparotomy was carried out which revealed a small perforation in terminal ileum associated with multiple circular indurated areas ranging from few mm to 1.5 Cm in size with central thinning spread over distal half of small gut and enlarged mesenteric lymph nodes. The biopsy of perforated area revealed cytomegaloviral enteritis. Postoperatively patient developed ARDS and died on 13th postoperative day.
Insights
A patient with inflammatory bowel disease and autoimmune hepatitis developed a perforated ileum due to cytomegaloviral enteritis. Despite treatment, the patient experienced complications including acute respiratory distress syndrome and ultimately died.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Hepatology
Background:
- A 47-year-old male presented with a four-month history of abdominal pain and loose stools.
- Initial investigations revealed anemia, deranged liver and renal function tests, an antral ulcer, and a cecal ulcer.
- Histopathology suggested inflammatory colitis and autoimmune hepatitis.
Related Concept Videos
Esophageal Perforation-I: Introduction
The location of esophageal perforation can vary, occurring anywhere along the esophagus.
Esophageal Perforation-II: Clinical Manifestations and Management
Clinical Manifestations:
Cytomegalovirus Disease
Appendicitis-I: Introduction
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
Bacterial Gastroenteritis
Appendicitis
