Endoscopy 2025; 57(S 02): S319
DOI: 10.1055/s-0045-1805784
Abstracts | ESGE Days 2025
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Ulcerative Stenosing Multifocal Cryptogenetic Enteritis: A Case Report

Authors

  • F J Puchol Rodrigo

    1   General University Hospital of Alicantet, Alacant, Spain

  • L Compañy Catalá

    2   University General Hospital Dr. Balmis, Alicante, Spain

  • N Sala Miquel

    2   University General Hospital Dr. Balmis, Alicante, Spain

  • O Belén Galipienso

    1   General University Hospital of Alicantet, Alacant, Spain

  • A Tirado-Escuder

    3   General University Hospital of Alicante, Alacant, Spain

  • J A Andreu-Viseras

    3   General University Hospital of Alicante, Alacant, Spain

  • V Moreno-Torres

    3   General University Hospital of Alicante, Alacant, Spain

  • G Kaur Singh

    4   University General Hospital Dr. Balmis, 03010s3, Spain

  • J R Aparicio

    2   University General Hospital Dr. Balmis, Alicante, Spain
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Cryptogenic multifocal ulcerative stenosing enteritis (c-MUSE) is a disease characterized by chronic and recurrent stenoses of the small intestine, with an idiopathic cause. It can lead to anemia, abdominal pain, and bleeding. Macroscopic findings with enteroscopy include multifocal ulcers and stenosis in the small bowel, and the histology would reveal ulceration, fibrosis and nonspecific inflammation.

We present the case of a 75-year-old woman with chronic anemia under follow-up by our Gastroenterology unit. Gastroscopies and colonoscopies showed no pathological findings. A capsule endoscopy was performed, revealing in the distal duodenum and proximal jejunum mucosa with edematous villi and linear ulcers that occupied the entire lumen. These findings raised a differential diagnosis between ulcerative jejunitis, Crohn's disease, lymphoma, and NSAID-induced enteritis [1] [2].

One month later, a Power Spiral enteroscopy was performed, observing two fibrin-covered ulcers in the third part of the duodenum, taking biopsies of them. Histology revealed chronic and acute inflammation, as well as reactive epithelial changes, with no evidence of malignancy.

Magnetic resonance enterography identified four segments in the jejunum with asymmetric mural thickening. A clear etiology could not be established (the patient denied NSAID use). Therefore, c-MUSE has been proposed as the diagnosis, given the stenosis and ulceration of the small intestine without a clear apparent cause.

Currently, due to the absence of symptoms or abnormalities in blood tests, the patient is not receiving any treatment.



Publication History

Article published online:
27 March 2025

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