Ulcerative colitis-associated diffuse enteritis without prior colectomy: A case report

Area of Science:

• Gastroenterology
• Inflammatory Bowel Disease
• Small Bowel Disorders

Background:

• Ulcerative colitis (UC) is a chronic inflammatory bowel disease primarily affecting the colon.
• Small bowel involvement in UC is rare, often associated with ileal pouch formation after colectomy.
• Emerging evidence suggests UC can cause small bowel inflammation in patients without prior surgery.

Purpose of the Study:

• To report a case of ulcerative colitis-associated small bowel inflammation in a patient without prior colectomy.
• To highlight diagnostic challenges and therapeutic options for this uncommon UC complication.

Main Methods:

• A 27-year-old female with a 6-year history of UC presented with abdominal pain.
• Diagnosis was confirmed via small bowel endoscopy, histopathology, and imaging.
• Patient initially unresponsive to steroids, subsequently treated with infliximab.

Main Results:

• Small bowel endoscopy revealed duodenal and jejunal ulcers.
• Histopathology showed inflammation, hemorrhage, and reduced crypt density.
• Infliximab therapy led to significant clinical improvement, mucosal healing, and steroid-free remission.

Conclusions:

• Ulcerative colitis can cause small bowel inflammation in patients without prior colectomy.
• Symptoms like abdominal pain may be distinct from typical UC manifestations.
• Biologic therapy, such as infliximab, is a potential effective treatment for refractory cases.