Abstract:
PURPOSE OF REVIEW:Increasing use of small bowel endoscopy unravels ulcers in a relevant number of patients. Although often attributed to inflammatory bowel disease (IBD), these ulcers may be unspecific or caused by a variety of other diseases. This review summarizes the recent literature related to differential diagnosis of small bowel ulcers. RECENT FINDINGS:NSAID enteropathy is the major differential diagnosis to IBD in patients with small bowel ulcers. Intestinal tuberculosis must be considered in patients at risk. Rare causes for small bowel ulcers are autoinflammatory, neoplastic, vascular diseases, or nontuberculous infections. Morphology of small bowel ulcers cannot provide a reliable differentiation, and even histology is not specific in all cases. History with special focus on NSAID medication and clinical symptoms not typical for IBD, laboratory tests in the search of systemic disease, and microbiologic testing of biopsies can be helpful. Genetic testing allows identification of few rare entities like defects in prostaglandin metabolism. SUMMARY:Due to a massive overlap in the endoscopic appearance of small bowel ulcers between possible causes, diagnosis should be based on broad information also including history, histology, imaging, and laboratory tests.
journal_name
Curr Opin Gastroenteroljournal_title
Current opinion in gastroenterologyauthors
Keuchel M,Kurniawan N,Baltes Pdoi
10.1097/MOG.0000000000000522subject
Has Abstractpub_date
2019-05-01 00:00:00pages
213-222issue
3eissn
0267-1379issn
1531-7056journal_volume
35pub_type
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journal_title:Current opinion in gastroenterology
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pub_type: 杂志文章,评审
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更新日期:2006-07-01 00:00:00
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journal_title:Current opinion in gastroenterology
pub_type: 杂志文章,评审
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更新日期:2009-05-01 00:00:00
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journal_title:Current opinion in gastroenterology
pub_type: 杂志文章
doi:10.1097/00001574-199901000-00012
更新日期:1999-01-01 00:00:00
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journal_title:Current opinion in gastroenterology
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doi:10.1097/00001574-200011000-00009
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journal_title:Current opinion in gastroenterology
pub_type: 杂志文章,评审
doi:10.1097/MOG.0b013e328334df17
更新日期:2010-03-01 00:00:00
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doi:10.1097/MOG.0b013e32833d1746
更新日期:2010-09-01 00:00:00
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journal_title:Current opinion in gastroenterology
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