Skip to main content
Gut logoLink to Gut
. 1983 Jun;24(6):565–574. doi: 10.1136/gut.24.6.565

Small intestinal ulceration: diagnostic difficulties in relation to coeliac disease.

D A Robertson, M F Dixon, B B Scott, F G Simpson, M S Losowsky
PMCID: PMC1420003  PMID: 6852635

Abstract

Seven cases of ulceration of the small intestine are described and the relationship to coeliac disease is discussed. Evidence for coeliac disease is found in all cases but is less strong in some than in others, and coeliac disease was proved in only two cases. The ulcers were examined histologically in each case and in three cases were associated with malignant histiocytosis but the others showed only non-specific chronic inflammation. This suggests a spectrum of disorders with an inconsistent relationship to gluten sensitivity and small intestinal lymphoma.

Full text

PDF
565

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. A case of malabsorption, intestinal mucosal atrophy and ulceration, cirrhosis, and emphysema. Br Med J. 1970 Jul 25;3(5716):207–212. doi: 10.1136/bmj.3.5716.207. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Baer A. N., Bayless T. M., Yardley J. H. Intestinal ulceration and malabsorption syndromes. Gastroenterology. 1980 Oct;79(4):754–765. [PubMed] [Google Scholar]
  3. Bayless T. M., Kapelowitz R. F., Shelley W. M., Ballinger W. F., 2nd, Hendrix T. R. Intestinal ulceration--a complication of celiac disease. N Engl J Med. 1967 May 4;276(18):996–1002. doi: 10.1056/NEJM196705042761802. [DOI] [PubMed] [Google Scholar]
  4. Brzechwa-Ajdukiewicz A., McCarthy C. F., Austad W., Cornes J., Harrison W. J., Read A. E. Carcinoma, villous atrophy, and steatorrhoea. Gut. 1966 Dec;7(6):572–577. doi: 10.1136/gut.7.6.572. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. CREAMER B. MALIGNANCY AND THE SMALL-INTESTINAL MUCOSA. Br Med J. 1964 Dec 5;2(5422):1435–1436. doi: 10.1136/bmj.2.5422.1435. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Deller D. J., Murrell T. G., Blowes R. Jejunal biopsy in malignant disease. Australas Ann Med. 1967 Aug;16(3):236–241. doi: 10.1111/imj.1967.16.3.236. [DOI] [PubMed] [Google Scholar]
  7. Doherty M., Barry R. E. Gluten-induced mucosal changes in subjects without overt small-bowel disease. Lancet. 1981 Mar 7;1(8219):517–520. doi: 10.1016/s0140-6736(81)92860-9. [DOI] [PubMed] [Google Scholar]
  8. Dymock I. W., MacKay N., Miller V., Thomson T. J., Gray B., Kennedy E. H., Adams J. F. Small intestinal function in neoplastic disease. Br J Cancer. 1967 Sep;21(3):505–511. doi: 10.1038/bjc.1967.59. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. FLICK A. L., QUINTON W. E., RUBIN C. E. A peroral hydraulic biopsy tube for multiple sampling at any level of the gastro-intestinal tract. Gastroenterology. 1961 Jan;40:120–126. [PubMed] [Google Scholar]
  10. Falchuk Z. M., Rogentine G. N., Strober W. Predominance of histocompatibility antigen HL-A8 in patients with gluten-sensitive enteropathy. J Clin Invest. 1972 Jun;51(6):1602–1605. doi: 10.1172/JCI106958. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Hamilton J. D., Chambers R. A., Wynn-Williams A. Role of gluten, prednisone, and azathioprine in non-responsive coeliac disease. Lancet. 1976 Jun 5;1(7971):1213–1216. doi: 10.1016/s0140-6736(76)92162-0. [DOI] [PubMed] [Google Scholar]
  12. Isaacson P., Wright D. H. Malignant histiocytosis of the intestine. Its relationship to malabsorption and ulcerative jejunitis. Hum Pathol. 1978 Nov;9(6):661–677. doi: 10.1016/s0046-8177(78)80049-5. [DOI] [PubMed] [Google Scholar]
  13. LEE F. D. PYLORIC METAPLASIA IN THE SMALL INTESTINE. J Pathol Bacteriol. 1964 Apr;87:267–277. doi: 10.1002/path.1700870207. [DOI] [PubMed] [Google Scholar]
  14. Lowenfels A. B. Why are small-bowel tumours so rare? Lancet. 1973 Jan 6;1(7793):24–26. doi: 10.1016/s0140-6736(73)91228-2. [DOI] [PubMed] [Google Scholar]
  15. MACDONALD W. C., BRANDBORG L. L., FLICK A. L., TRIER J. S., RUBIN C. E. STUDIES OF CELIAC SPRUE. IV. THE RESPONSE OF THE WHOLE LENGTH OF THE SMALL BOWEL TO A GLUTEN-FREE DIET. Gastroenterology. 1964 Dec;47:573–589. [PubMed] [Google Scholar]
  16. Marsh G. W., Stewart J. S. Splenic function in adult coeliac disease. Br J Haematol. 1970 Oct;19(4):445–457. doi: 10.1111/j.1365-2141.1970.tb06972.x. [DOI] [PubMed] [Google Scholar]
  17. Mills P. R., Brown I. L., Watkinson G. Idiopathic chronic ulcerative enteritis. Report of five cases and review of the literature. Q J Med. 1980 Spring;49(194):133–149. [PubMed] [Google Scholar]
  18. Stokes P. L., Asquith P., Holmes G. K., Mackintosh P., Cooke W. T. Histocompatibility antigens associated with adult coeliac disease. Lancet. 1972 Jul 22;2(7769):162–164. doi: 10.1016/s0140-6736(72)91330-x. [DOI] [PubMed] [Google Scholar]
  19. Wall A. J., Douglas A. P., Booth C. C., Pearse A. G. Response of the jejunal mucosa in adult coeliac disease to oral prednisolone. Gut. 1970 Jan;11(1):7–14. doi: 10.1136/gut.11.1.7. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Yokoyama I., Kozuka S., Ito K., Kubota K., Yokoyama Y. Gastric gland metaplasia in the small and large intestine. Gut. 1977 Mar;18(3):214–218. doi: 10.1136/gut.18.3.214. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES