{"id":166,"date":"2017-09-21T09:36:21","date_gmt":"2017-09-21T09:36:21","guid":{"rendered":"http:\/\/stg-blogs.bmj.com\/fg\/?p=166"},"modified":"2017-09-21T10:25:55","modified_gmt":"2017-09-21T10:25:55","slug":"an-unusual-cause-of-intestinal-failure","status":"publish","type":"post","link":"https:\/\/stg-blogs.bmj.com\/fg\/2017\/09\/21\/an-unusual-cause-of-intestinal-failure\/","title":{"rendered":"An unusual cause of intestinal failure"},"content":{"rendered":"<p>A 62 year old man with well controlled type 2 diabetes presented with abdominal symptoms, significant weight loss and night blindness. He was vitamin A deficient, had marked peripheral oedema and a serum albumin of 12g\/l, requiring TPN.<br \/>\nStool culture and testing for HIV and TB were negative. Immunoglobulin levels were normal.<br \/>\nComputed tomography showed mesenteric inflammatory fat stranding and enlarged lymph nodes\u00a0(Figure 1). Colonoscopy was unremarkable.<br \/>\nHistology revealed inflamed and ulcerated small bowel mucosa with plump endothelial cells. (Figure 2) There were no granulomata.<br \/>\nEnteroscopy showed granular oedematous mucosa and deep ulcerations. (Figure 3).<br \/>\nWhat is the differential diagnosis?<\/p>\n<p style=\"text-align: center\"><a href=\"https:\/\/stg-blogs.bmj.com\/fg\/files\/2017\/09\/gstead-COM-Sep17.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-169\" src=\"https:\/\/stg-blogs.bmj.com\/fg\/files\/2017\/09\/gstead-COM-Sep17-300x225.png\" alt=\"\" width=\"415\" height=\"311\" srcset=\"https:\/\/stg-blogs.bmj.com\/fg\/files\/2017\/09\/gstead-COM-Sep17-300x225.png 300w, https:\/\/stg-blogs.bmj.com\/fg\/files\/2017\/09\/gstead-COM-Sep17.png 720w\" sizes=\"auto, (max-width: 415px) 100vw, 415px\" \/><\/a><\/p>\n<p>Gavin Stead<!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>A 62 year old man with well controlled type 2 diabetes presented with abdominal symptoms, significant weight loss and night blindness. He was vitamin A deficient, had marked peripheral oedema and a serum albumin of 12g\/l, requiring TPN. Stool culture and testing for HIV and TB were negative. Immunoglobulin levels were normal. Computed tomography showed [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/stg-blogs.bmj.com\/fg\/2017\/09\/21\/an-unusual-cause-of-intestinal-failure\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-166","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"jetpack_featured_media_url":"","_links":{"self":[{"href":"https:\/\/stg-blogs.bmj.com\/fg\/wp-json\/wp\/v2\/posts\/166","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/stg-blogs.bmj.com\/fg\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/stg-blogs.bmj.com\/fg\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/fg\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/fg\/wp-json\/wp\/v2\/comments?post=166"}],"version-history":[{"count":0,"href":"https:\/\/stg-blogs.bmj.com\/fg\/wp-json\/wp\/v2\/posts\/166\/revisions"}],"wp:attachment":[{"href":"https:\/\/stg-blogs.bmj.com\/fg\/wp-json\/wp\/v2\/media?parent=166"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/fg\/wp-json\/wp\/v2\/categories?post=166"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/fg\/wp-json\/wp\/v2\/tags?post=166"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}