Cryptogenic multifocal ulcerous stenosing enteritis: Radiologic features and clinical behavior.

Area of Science:

• Gastroenterology
• Radiology
• Pathology

Background:

• Cryptogenic multifocal ulcerous stenosing enteritis (CMUSE) is a rare condition that can mimic other small bowel diseases.
• Accurate radiologic characterization is crucial for diagnosis and differentiating CMUSE from similar conditions.

Purpose of the Study:

• To identify and describe the characteristic radiologic findings of CMUSE.
• To assess the clinical behavior and diagnostic utility of imaging in CMUSE.

Main Methods:

• Retrospective review of imaging (small bowel series, CT/MR enterography) and clinical data from 20 pathologically confirmed CMUSE patients.
• Evaluation of enteric and perienteric manifestations, including strictures, wall thickening, and ulcerations.
• Correlation of radiologic findings with histopathology and clinical outcomes, including recurrence.

Main Results:

• The most common symptoms were abdominal pain and anemia.
• Characteristic findings included multiple short-segmental, circumferential small bowel strictures with layered enhancement, predominantly in the ileum.
• Shallow ulcers and wall thickening were noted, with some lesions progressing over time; no penetrating complications were observed.

Conclusions:

• Characteristic radiologic findings of multiple short-segmental strictures and shallow ulcers in the small intestine are indicative of CMUSE.
• Imaging plays a vital role in diagnosing CMUSE, especially in patients presenting with recurrent abdominal pain and anemia.
• CMUSE requires consideration in the differential diagnosis of unexplained small bowel strictures and ulcerations.