PMC4748195_01
Small bowel capsule study showing the (A) proximal jejunum and (B) proximal ileum.
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F1
A capsule endoscopy showed scalloped mucosal folds in the duodenum and proximal jejunum, and moderate to severe mucosal congestion, granularity, and cobblestoning with luminal narrowing involving the distal jejunum to the distal ileum (Figure 1).
Figure 2. Biopsy of duodenum with H&E stain at x40 magnification demonstrating dilated duodenal crypt containing necrotic debris.
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F2
One of the duodenal biopsies also revealed dilated crypts with necrotic debris in the lumen, which raised the possibility of small bowel injury from mycophenolate mofetil (Figure 2).