Non-specific ulcers of the small intestine: causes, symptoms, diagnosis, treatment

Non-specific ulcers of the small intestine are extremely rare. Only isolated descriptions of this disease can be found in the literature. These are non-specific ulcers, unlike ulcerations of an established nature, which can be tuberculous, syphilitic, and cancerous. It is believed that this disease is approximately 3 times more common in men than in women, and is found in people of predominantly middle and old age.

The causes and pathogenesis of the disease are unknown. Since the pathomorphological picture is more often dominated by acute necrosis than by changes characteristic of chronic (peptic) gastroduodenal ulcer, it can be assumed that local vascular factors (embolism, thrombosis), local mechanical damage to the mucous membrane or focal inflammatory process can be the cause of these diseases.

Symptoms, course and complications. Small intestinal ulcers can be acute or chronic, asymptomatic or with atypical pain in the paraumbilical region. However, most often they first manifest suddenly with symptoms of intestinal perforation and the clinical picture of an acute abdomen. Thus, having analyzed 130 reports described in the literature on primary non-specific ulcers of the small intestine, it was found that in 81 cases it was ulcer perforation.

In rarer cases, small intestinal ulcers are complicated by intestinal bleeding.

Clinical diagnosis is difficult. Only in rare cases, in the presence of ulcer-like pain and signs of repeated intestinal bleeding, by excluding peptic ulcer disease and other diseases of the gastroduodenal zone, as well as lesions of the large intestine, the doctor can come to the conclusion about a possible disease of the small intestine and orient the radiologist to a targeted examination of this section of the intestine. However, even radiologically, due to the known difficulties associated with the structural features of the mucous membrane of the small intestine, as well as the location of the intestine, it is difficult to detect an ulcer of the small intestine. If the ulcer has perforated or massive intestinal bleeding has occurred, ulcers of the small intestine can often be detected during laparotomy and resection of the gastrointestinal tract.

Signs of perforation of a small intestinal ulcer do not differ from those of perforation of a peptic gastroduodenal ulcer.

In chronic ulcers, a rare complication is stenosis of the intestinal lumen.

Treatment of small intestinal ulcers is therapeutic, poorly developed in uncomplicated cases. Since there is never any certainty that an ulcer represents an ulceration of a tumor, surgical treatment is more appropriate. In complicated and diagnostically questionable cases - surgical treatment.

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