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Small bowel (small intestine)

Inflammatory disorders

Diaphragm disease


Reviewer: Nat Pernick, M.D. (see Reviewers page)
Revised: 15 December 2012, last major update August 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.

General
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● Small bowel pathology related to NSAID use, first described in 1988 (J Clin Pathol 1988;41:516)

Treatment
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● Cessation of NSAID use
● Often surgery (Colorectal Dis 2012;14:804) or endoscopic balloon dilation (Gastrointest Endosc 2006;64:1014)

Case reports
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● 46 year old woman with chronic aspirin use (Case of the Week #240)

Gross description
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● Segmentation of ileum by incomplete mucosal diaphragms, defined as thin circumferential membranes resembling the plica circularis, composed of mucosa and submucosa with accompanying fibrosis
● Also ulceration, strictures, perforation

Gross images
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Various images

Micro description
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● Thin circumferential membranes resembling plica circularis, composed of mucosa and submucosa with accompanying fibrosis
● Neuromuscular and vascular hamartoma-like changes, eosinophilic enteritis and acute inflammation (Am J Clin Pathol 2008;130:518).

Micro images
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Top row: H&E; bottom row: trichrome

Differential diagnosis
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● Cryptogenic multifocal ulcerous stenosing enteritis (CMUSE): small intestinal strictures and ulcerations of unknown origin (World J Gastroenterol 2011;17:2873), characterized as atypical vasculitis presenting with unexplained stricture and ulceration of the small bowel in young and middle-aged patients, but without systemic inflammation; treated with steroids

End of Small bowel (small intestine) > Inflammatory disorders > Diaphragm disease


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