PMC6202987_01
(A) Small intestinal ulcer surrounding erythematous mucosal changes were revealed in small intestine by capsule endoscope (white arrow). (B) Balloon-assisted enteroscopy (with hood attached) revealed geographic ulcer in the jejunal-ileac junction (black arrow).
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F1
Images from the capsule showed small intestinal ulceration with surrounding erythematous mucosal changes in jejunum, which were likely to be the cause of the recent bleed (figure 1A). Despite the stenosis in area surrounding the jejunum-ileac junction, the scope was successfully inserted to the proximal ileum revealing geographic ulcers in the jejunal-ileac junction (figure 1B). Additionally, a brain MRI showed mild pachydermia in the forehead which was later confirmed by a dermatologist (online supplementary figure 1).
(A) Mild deformity in the duodenal bulb (black arrow). (B) Stenosis in jejunal-ileac junction (yellow arrow) with proximal dilatation (blue arrow).
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F2
A Roentgen barium study was later performed, which revealed small intestinal morphological changes that were similar to the earlier endoscopic findings, such as mild stenosis with deformity of duodenal bulb (figure 2) as well as stenosis in jejunal-ileac junction along with proximal dilatation (figure 2).