Open AccessNot All that Strictures Is IBD
Author(s) -
Ralbovsky Amariel,
Reyna Troy,
Kabeer Mustafa,
Nael Ali,
Yang Christine
Publication year - 2022
Publication title -
jpgn reports
Language(s) - English
Resource type - Journals
ISSN - 2691-171X
DOI - 10.1097/pg9.0000000000000106
Subject(s) - medicine , gastroenterology , inflammatory bowel disease , colonoscopy , abdominal pain , enteroscopy , perforation , laparotomy , bowel obstruction , ileum , endoscopy , radiology , disease , materials science , colorectal cancer , cancer , punching , metallurgy
A 14‐year‐old male presented with worsening chronic intermittent abdominal pain, mild anemia, positive fecal occult blood test, and elevated calprotectin. Computerized tomography and magnetic resonance imaging showed ileal dilation with mucosal enhancement and inflammatory changes suspicious for inflammatory bowel disease (IBD). Prominent mucosal folds were suggestive of gastric heterotopia, but Meckel's scan was negative. Upper endoscopy, colonoscopy, and double balloon enteroscopy were grossly and microscopically normal. Laparotomy revealed 17 cm of a dense, inflamed, stenotic segment of ileum. The strictured ileum had perforated and had been concealed by an adjacent loop of small bowel, ultimately producing an obstructive IBD‐like picture, but was found to be histologically consistent with gastric oxyntic mucosa. This case illustrates the challenges of diagnosing and treating heterotopic gastric mucosa, and the importance of considering diagnoses other than IBD when evaluating stricturing disease of the small bowel.