Ulcer of the Small Intestine, Nonspecific (Idiopathic, Peptic, Trophic, Round, etc.)

Primary ulcer of the small intestine is a rare disease characterized by the appearance of one or multiple ulcerations mainly in the ileum, reminiscent in morphology of peptic ulcers of the stomach and duodenum. Occurs predominantly in men. Etiology and pathogenesis are unknown.

Predisposing factors are local vascular disorders, increased tryptic activity of pancreatic juice, long-term use of certain drugs (prednisolone, potassium salts, etc.). Symptoms are uncommon and the diagnosis is often made during surgery if complications occur (perforation, intestinal bleeding).

Pain in the epigastrium or right iliac region is sometimes observed, occurring 3-4 hours after eating, local soreness in this area and muscle tension in the anterior abdominal wall upon palpation. Stool examination reveals occult bleeding. With a targeted X-ray examination, it is sometimes possible to detect an ulcerative niche in the small intestine.

Differential diagnosis is carried out with tuberculous ulcers, ulcers of the small intestine with typhoid fever, amyloidosis, regional enteritis, disintegrating tumor.

Possible complications: intestinal bleeding, perforation, intestinal stenosis. Treatment: surgical treatment is preferable, absolutely indicated in case of complications and in diagnostically doubtful cases (tumor ulceration cannot be ruled out).