Cytomegalovirus enteritis in immunocompetent patients: Report of two cases diagnosed using single‐balloon enteroscopy

ADVANCES IN DIGESTIVE MEDICINE - Tập 3 - Trang 135-140 - 2016
Cheng-Lin Hsieh1, Chia-Hung Tu1, Min-Horn Tsai2, Cher-Wei Liang3, Hsiu-Po Wang1, Ping-Huei Tseng1
1Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
2Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, HsinChu, Taiwan
3Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan

Tóm tắt

SummaryCytomegalovirus (CMV) infection of the gastrointestinal tract involves mostly the colon and rectum and mainly develops in immunocompromised patients. CMV infection in the small intestines has rarely been reported in immunocompetent patients. We report two cases of CMV enteritis that developed in immunocompetent patients and involved the ileum and jejunum, respectively. Both of them were diagnosed with single‐balloon enteroscopy (SBE) and further confirmed with histopathology. The first case is a 71‐year‐old woman with a presentation of obscure gastrointestinal bleeding and severe anemia. Neither esophagogastroduodenoscopy nor colonoscopy identified any active bleeding. SBE and biopsy disclosed multiple scattered ulcers in the distal ileum and histopathology confirmed CMV ileitis. The hemorrhage subsided after conservative medical treatment. The second case is a 59‐year‐old woman with a presentation of progressive abdominal pain. SBE showed diffuse irregularly‐shaped ulcers located from the upper to middle jejunum, and CMV jejunitis was confirmed with endoscopic biopsy and histopathological examination. Antiviral therapy was prescribed and her abdominal pain improved gradually. We discuss the clinical manifestations and management strategies of CMV infection that develops in the small intestines of immunocompetent patients. In addition, we highlight the endoscopic characteristics of CMV enteritis and the clinical utilities of SBE in the evaluation of patients with suspected CMV infection of the small intestines.

Tài liệu tham khảo

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ADVANCES IN DIGESTIVE MEDICINE

Tập 3

135-140

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