Abstract：
BACKGROUND Cryptogenic multifocal ulcerating stenosing enteropathy (CMUSE) is a rare noninfectious chronic inflammatory disease of the digestive tract confined to the small bowel. Chronic inflammatory wasting leads to protein loss and weight reduction, and some patients eventually develop small bowel stenosis. The etiopathogenesis of CMUSE remains unknown. CASE REPORT A thin 62-year-old man was admitted to the hospital with abdominal pain and distension accompanied by bilateral lower-extremity edema for 2 months. After a series of medical tests, rheumatic or immune-related diseases, hyperthyroidism, and tuberculosis were excluded, and common digestive system diseases were also excluded. Abdominal CT showed incomplete obstruction of the small bowel. Enteroscopy showed small-bowel luminal narrowing. The patient subsequently underwent partial resection of the small bowel with end-to-side anastomosis. The small-bowel stricture was about 120 cm from the ileocecal junction, and about 12 cm of small bowel was resected. Postoperative pathology of the resected material revealed multifocal ulceration of the mucosa with massive inflammatory cell infiltration and extensive hyperplastic fibrous tissue, consistent with the characteristics of CMUSE disease. At follow-up 6 months after surgery, he had no abdominal pain or distension, and his anemia and lower-extremity edema were improved. CONCLUSIONS CMUSE diagnosis requires a combination of patient history, imaging, endoscopy, pathology, and exclusion of other digestive disorders, such as Crohn\'s disease. It is a chronic wasting disease, often accompanied by weight loss, abdominal pain, melena, and hypoproteinemia. Surgery is an important treatment for intestinal strictures caused by CMUSE.
摘要：
背景技术隐源性多灶性溃疡性狭窄性肠病(CMUSE)是局限于小肠的一种罕见的消化道非感染性慢性炎性疾病。慢性炎症消耗导致蛋白质减少和体重减轻，一些患者最终发展为小肠狭窄。CMUSE的病因尚不清楚。病例报告1名62岁瘦弱男子因腹痛、腹胀伴双侧下肢水肿住院2个月。经过一系列的医学检查,风湿性或免疫相关疾病，甲状腺功能亢进,结核病被排除在外，也排除了常见的消化系统疾病。腹部CT显示小肠不完全梗阻。肠镜检查显示小肠管腔狭窄。患者随后接受了小肠的部分切除术，并进行了端侧吻合。小肠狭窄距离回盲部约120厘米，切除约12厘米的小肠。切除材料的术后病理显示粘膜多灶性溃疡伴大量炎性细胞浸润和广泛增生的纤维组织，符合CMUSE病的特点。在手术后6个月的随访中，他没有腹痛或腹胀，贫血和下肢水肿得到改善。结论CMUSE诊断需要结合患者病史，成像,内窥镜检查,病理学,排除其他消化系统疾病，比如克罗恩病。这是一种慢性消耗性疾病，经常伴随着体重减轻，腹痛,Melena,和低蛋白血症。手术是治疗CMUSE引起的肠道狭窄的重要方法。
