Endoscopic Features of Chronic Nonspecific Multiple Ulcers of the Small Intestine: Comparison with Nonsteroidal Anti-inflammatory Drug-Induced Enteropathy

Chronic nonspecific multiple ulcers of the small intestine (CNSU) and nonsteroidal anti-inflammatory drug-induced enteropathy (NSAID-enteropathy) share common clinicopathologic features characterized by histologically nonspecific ulcers and persistent blood loss. The aim was to compare enteroscopic findings between CNSU and NSAID-enteropathy. Four patients with CNSU and five patients with NSAID-enteropathy were examined by enteroscopies. The site of involvement was heterogeneous in NSAID-enteropathy, while the ileum was the predominant site in CNSU. Three patients with NSAID-enteropathy and all four patients with CNSU had concentric stenosis. Circular ulcers were found in all five patients with NSAID-enteropathy and in three patients with CNSU. Active ulcer was seen in only two patients with NSAID-enteropathy. In contrast, all four patients with CNSU had active ulcer. These findings suggest that in patients with persistent GI bleeding and enteroscopically active small intestinal ulcers, CNSU, as well as NSAID-enteropathy, should be considered.