Case Report
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World J Gastrointest Endosc. May 16, 2012; 4(5): 194-196
Published online May 16, 2012. doi: 10.4253/wjge.v4.i5.194
Double-balloon endoscopy-diagnosed multiple small intestinal ulcers in a Churg-Strauss syndrome patient
Takayoshi Suzuki, Masashi Matsushima, Yoshitaka Arase, Mia Fujisawa, Ichiro Okita, Muneki Igarashi, Jun Koike, Tetsuya Mine
Takayoshi Suzuki, Masashi Matsushima, Yoshitaka Arase, Mia Fujisawa, Ichiro Okita, Muneki Igarashi, Jun Koike, Tetsuya Mine, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Kanagawa 259-1193, Japan
Author contributions: Suzuki T wrote the paper and performed double-balloon endoscopy; Arase Y, Fujisawa M, Okita I, Igarashi M and Koike J were responsible for data collection; Matsushima M and Mine T reviewed this manuscript.
Correspondence to: Takayoshi Suzuki, MD, PhD, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara City, Kanagawa, 259-1193, Japan. takayosh@is.icc.u-tokai.ac.jp
Telephone: +81-463-931121 Fax: +81-463-914175
Received: March 30, 2011
Revised: September 12, 2011
Accepted: March 30, 2012
Published online: May 16, 2012
Abstract

Churg-Strauss syndrome (CSS) is a systemic vascular disorder characterized by severe bronchial asthma, hypereosinophilia, and allergic rhinitis. Small intestinal ulcers associated with CSS are a relatively rare manifestation that causes gastrointestinal bleeding. Multiple deep ulcers with an irregular shape are characteristic of small intestinal involvement of CSS. Video-capsule-endoscopy (VCE), double-balloon endoscopy (DBE) and Spirus assisted enteroscopy have been developed recently and enabled observation of the small intestine. In this case report, we have described a patient with CSS who had multiple deep ulcers in the jejunum detected by oral DBE. Since severe gastrointestinal (GI) involvement has been identified as an independent factor associated with poor outcome, the careful investigation of GI tract must be needed for CSS patients with GI symptoms. We describe the usefulness of DBE for diagnosis of small intestinal ulcers in patient with CSS.

Keywords: Churg-Strauss syndrome; Small intestinal ulcers; Double-balloon endoscopy