Year 2015 / Volume 107 / Number 8
Digestive Diseases Image
Intestinal intussusception as an atypical presentation of celiac disease

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Enrique Pérez-Cuadrado-Robles, Paloma Bebia-Conesa, Blanca Martínez-Andrés, Pilar Esteban-Delgado, Antonio López-Higueras and Enrique Pérez-Cuadrado-Martínez

Abstract
CASE REPORT
A 31-year-old woman was studied because of chronic ferro- penic anemia and colicky abdominal pain for many years. An upper gastrointestinal endoscopy was performed that revealed no mucosal changes, with a normal villous pattern and normal duodenal biopsy. Colonoscopy yielded no findings. A CT scan revealed a thickened jejunal wall with mesenteric adenopathies and no evidence of intestinal ischemia or obstruction. Capsule endoscopy (CE) was indicated, which revealed from the proximal jejunum the characteristic, diffusely cracked mucosa of celiac disease (CD), with atrophy and a mosaic pattern (Fig. 1A). A jeju- no-jejunal invagination was identified in the distal jejunum (Fig. 1B) with a transition of normal mucosa over the involved mucosa that might correspond to the image shown by CT. CE showed a preserved villous pattern in the distal small bowel. A subsequent double-balloon enteroscopy with histopathologic study confirmed the presence of patchy CD in the proximal jejunum.
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Enrique Pérez-Cuadrado-Robles, Paloma Bebia-Conesa, Blanca Martínez-Andrés, Pilar Esteban-Delgado, Antonio López-Higueras and Enrique Pérez-Cuadrado-Martínez. Intestinal intussusception as an atypical presentation of celiac disease. 509


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