Nonsteroidal Anti-inflammatory Drug-Induced Enteropathy and Other Inflammatory Lesions of the Small Bowel

Abstract

Inflammatory lesions of the small bowel, other than those found in inflammatory bowel disease (IBD), are diverse and can result from a variety of insults including nonsteroidal anti-inflammatory drug (NSAID)-induced enteropathy, infectious disease such as tuberculous or cytomegalovirus enteritis, ischemia, and others. Although capsule endoscopy (CE) and device-assisted enteroscopy (DAE) are available, the differential diagnosis of small bowel disease can be difficult. CE findings of NSAID-induced enteropathy range from erosions or ulcers to severe lesions such as diaphragms. Tuberculous enteritis may occur frequently on the antimesenteric side of the intestine, which can result in a patulous ileocecal valve, transverse ulcers, pseudopolyps, strictures, and cicatricial changes. Endoscopic findings of edematous mucosal lesions with a loss of vascular vessels or a dusky pattern with scattered discrete ulcerations and strictures may be observed in patients with ischemia. Portal hypertensive enteropathy can be classified into mucosal inflammatory-like abnormalities and vascular lesions. This chapter summarizes the experience with CE and DAE for various inflammatory lesions except IBD of the small bowel.