More than meets the eye: a strange cause of bowel obstruction and perforation

Case presentation A 55-year-old man presented with abdominal distension, vomiting, fever for 3 days and weight loss. He smoked 40 cigarettes and drank 100 g of alcohol per day. He had no documented medical or drug history and no history of receptive anal intercourse. Abdominal examination revealed diffuse tenderness. Laboratory values disclosed neutrophilia (13 720/µL), normocytic anaemia (7.4 g/dL), hypoalbuminaemia (25.2 g/L) and elevated inflammatory markers (C reactive protein of 70.27 mg/L, procalcitonin of 5.200 ng/mL), without eosinophilia (140/µL). HIV serology was negative. Stool was positive for occult blood, but parasite examination was negative. CT of the chest indicated diffuse lung inflammation. Contrast-enhanced CT of the abdominal showed air-filled dilated bowel loops with fluid levels and extensive wall thickening suggestive of small bowel obstruction and active enteritis (figure 1). Gastrointestinal endoscopy showed a 0.5x0.6 cm pyloric ulcer (figure 2A), multiple shallow ulcers in the ileocecal junction (figure...

Source: Gut - November 24, 2023 Category: Gastroenterology Authors: Huang, W.-F., Ding, Y., Sun, J., Zhang, J.-Y. Tags: GUT Snapshot, Gut Editor ' s quiz: GI snapshot Source Type: research