Yumna Njoum, Mohammed Hinnawi, Khaled Alshawwa, Hamza A Abdul-Hafez, Omar AbuZaydeh, Bashar Jaber
{"title":"急性肠梗阻显示未确诊空肠结节病59岁女性。","authors":"Yumna Njoum, Mohammed Hinnawi, Khaled Alshawwa, Hamza A Abdul-Hafez, Omar AbuZaydeh, Bashar Jaber","doi":"10.1097/MS9.0000000000003085","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Sarcoidosis is a granulomatous illness with no known cause, defined histopathologically by noncaseating granulomas. While 90% of cases involve the lungs and mediastinal lymph nodes, clinically recognizable gastrointestinal sarcoidosis occurs in only 0.1-0.9% of patients, with small bowel involvement occurring in as few as 0.03% of all cases, and when it does occur, it is usually late in the disease course in patients with multisystem disease.</p><p><strong>Case presentation: </strong>Herein, we report a case of 59-year-old patient who presented with a picture of complete jejunal obstruction and gastrointestinal bleeding. Imaging revealed jejunal thickening and mesenteric lymphadenopathy. Later, intra-operatively, it be found caused by a jejunal stricture and enlarged mesenteric lymph nodes secondary to an undiagnosed sarcoidosis. Postoperative complications included hepatic hematoma and gastrointestinal bleeding. She stabilized after multidisciplinary management. A 1-year follow-up showed mediastinal lymphadenopathy without pulmonary involvement.</p><p><strong>Discussion: </strong>To provide individualized therapeutic care and follow-up, gastrointestinal sarcoidosis is a complex, possibly lethal condition that requires a multidisciplinary approach and early clinical suspicion. Without a prior diagnosis, sarcoidosis must be taken into account as a possible cause of acute intestinal blockage.</p><p><strong>Conclusion: </strong>Our case of jejunal sarcoidosis is unique for the rarity of disease location, the lack of pre-existing diagnosed sarcoidosis, and the necrotized jejunal resected segment indicating bowel ischemia.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 5","pages":"2996-3001"},"PeriodicalIF":1.7000,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055183/pdf/","citationCount":"0","resultStr":"{\"title\":\"Acute intestinal obstruction revealing an undiagnosed jejunal sarcoidosis in a 59-year-old female.\",\"authors\":\"Yumna Njoum, Mohammed Hinnawi, Khaled Alshawwa, Hamza A Abdul-Hafez, Omar AbuZaydeh, Bashar Jaber\",\"doi\":\"10.1097/MS9.0000000000003085\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Sarcoidosis is a granulomatous illness with no known cause, defined histopathologically by noncaseating granulomas. While 90% of cases involve the lungs and mediastinal lymph nodes, clinically recognizable gastrointestinal sarcoidosis occurs in only 0.1-0.9% of patients, with small bowel involvement occurring in as few as 0.03% of all cases, and when it does occur, it is usually late in the disease course in patients with multisystem disease.</p><p><strong>Case presentation: </strong>Herein, we report a case of 59-year-old patient who presented with a picture of complete jejunal obstruction and gastrointestinal bleeding. Imaging revealed jejunal thickening and mesenteric lymphadenopathy. Later, intra-operatively, it be found caused by a jejunal stricture and enlarged mesenteric lymph nodes secondary to an undiagnosed sarcoidosis. Postoperative complications included hepatic hematoma and gastrointestinal bleeding. She stabilized after multidisciplinary management. A 1-year follow-up showed mediastinal lymphadenopathy without pulmonary involvement.</p><p><strong>Discussion: </strong>To provide individualized therapeutic care and follow-up, gastrointestinal sarcoidosis is a complex, possibly lethal condition that requires a multidisciplinary approach and early clinical suspicion. Without a prior diagnosis, sarcoidosis must be taken into account as a possible cause of acute intestinal blockage.</p><p><strong>Conclusion: </strong>Our case of jejunal sarcoidosis is unique for the rarity of disease location, the lack of pre-existing diagnosed sarcoidosis, and the necrotized jejunal resected segment indicating bowel ischemia.</p>\",\"PeriodicalId\":8025,\"journal\":{\"name\":\"Annals of Medicine and Surgery\",\"volume\":\"87 5\",\"pages\":\"2996-3001\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-04-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055183/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of Medicine and Surgery\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1097/MS9.0000000000003085\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/5/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Medicine and Surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1097/MS9.0000000000003085","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/5/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Acute intestinal obstruction revealing an undiagnosed jejunal sarcoidosis in a 59-year-old female.
Background: Sarcoidosis is a granulomatous illness with no known cause, defined histopathologically by noncaseating granulomas. While 90% of cases involve the lungs and mediastinal lymph nodes, clinically recognizable gastrointestinal sarcoidosis occurs in only 0.1-0.9% of patients, with small bowel involvement occurring in as few as 0.03% of all cases, and when it does occur, it is usually late in the disease course in patients with multisystem disease.
Case presentation: Herein, we report a case of 59-year-old patient who presented with a picture of complete jejunal obstruction and gastrointestinal bleeding. Imaging revealed jejunal thickening and mesenteric lymphadenopathy. Later, intra-operatively, it be found caused by a jejunal stricture and enlarged mesenteric lymph nodes secondary to an undiagnosed sarcoidosis. Postoperative complications included hepatic hematoma and gastrointestinal bleeding. She stabilized after multidisciplinary management. A 1-year follow-up showed mediastinal lymphadenopathy without pulmonary involvement.
Discussion: To provide individualized therapeutic care and follow-up, gastrointestinal sarcoidosis is a complex, possibly lethal condition that requires a multidisciplinary approach and early clinical suspicion. Without a prior diagnosis, sarcoidosis must be taken into account as a possible cause of acute intestinal blockage.
Conclusion: Our case of jejunal sarcoidosis is unique for the rarity of disease location, the lack of pre-existing diagnosed sarcoidosis, and the necrotized jejunal resected segment indicating bowel ischemia.