Small Bowel Ulcerations

Content below is from a textbook reference chapter (Sabiston Ch50 - Diverticular Disease & Miscellaneous Problems), not primary literature.

Ulcerations of the small bowel are relatively uncommon and may be attributed to Crohn Disease, typhoid fever, tuberculosis, lymphoma, and gastrinoma (Table 50.11 in the source gives a full causal taxonomy — infections [TB, syphilis, CMV, typhoid, parasites, Strongyloides hyperinfection, Campylobacter, Yersinia], inflammatory [Crohn’s, SLE, celiac disease, ulcerative enteritis], ischemia, idiopathic [primary ulcer, Behçet syndrome], drug-induced [potassium, indomethacin, phenylbutazone, salicylates, antimetabolites], radiation, vascular [vasculitis, giant cell arteritis, amyloidosis, angiocentric lymphoma], metabolic [uremia], hyperacidity [Zollinger-Ellison syndrome, Meckel diverticulum, stomal ulceration], neoplastic [lymphoma, adenocarcinoma, melanoma], toxic [β-toxin–producing Clostridium perfringens, arsenic], and mucosal lesions [lymphocytic enterocolitis]).

Drug-induced ulcerations occur and were, in the past, attributed to enteric-coated potassium chloride tablets and corticosteroids. In addition, ulcerations of the small intestine in which no causative agent can be identified have been described. It is suggested that small bowel complications from NSAIDs may be more common than originally considered — NSAID-induced ulcers occur more commonly in the ileum, with single or multiple ulcerations noted. Complications necessitating operative intervention include bleeding, perforation, and obstruction. In addition to ulcerations, NSAIDs are known to induce an enteropathy characterized by increased intestinal permeability, leading to protein loss, hypoalbuminemia, malabsorption, and anemia. Treatment of complications from small bowel ulcerations is segmental resection and intestinal reanastomosis.

Open items / gaps

• No primary literature yet in the wiki on small bowel ulcerations/NSAID enteropathy specifically — entirely textbook-reference-derived.