CRYPTOGENIC MULTIFOCAL ULCEROUS STENOSING ENTERITIS (CMUSE): A 20-YEAR SINGLE CENTER CLINICAL AND RADIOLOGIC EXPERIENCE

Abstract Background Cryptogenic multifocal ulcerous stenosing enteritis (CMUSE) is a rare illness characterized by multiple strictures and shallow ulcers of the small bowel. Even though diagnostic criteria have been described, further ellucidation needed on therapeutic interventions potential discriminating factors between CMUSE other more common causes intestinal ulcerations, including Crohn’s disease. Aim The purpose this article to report clinical, CT, MR enterography characteristics confirmed cases CMUSE. Materials Methods Retrospective review electronic medical records identified 33 patients considered for diagnosis Diagnosis was if all requirements previously published were met. Patients excluded they had less than one year follow-up or incomplete clinical data. Two GI radiologists reviewed CT (CTE/MRE) exams in consensus characterize cross sectional imaging features. Results 9 (27%) 24 (73%) alternative diagnosis. disease (CD) (30%, n=7) drug-induced enteropathy most frequent alternative. Male gender (66.7% vs. 25%, p=0.04) manifestation anemia at presentation commonly observed CMUSE-confirmed 4.2%, p=0.005) when compared with non-CMUSE diagnosis, which abdominal pain presenting symptom (44.5% vs 87.5%, p=0.02). Multiple (100%) circumferential (75%) restricted mucosal involvement (55.6%) major features endoscopy pathology. Most treatments corticosteroids (78%) surgical resection (55.6%), 33% receiving biologics. Disease recurrence after first treatment occurred majority (88.9%) median time 6 months (Table 1). CTE 1 MRE 8 images analyzed 2). Major included (? 5; 88%; 7/8), short (< 2 cm; 100%; 8/8) (100%;8/8) moderate wall thickening (6–9 cm), stratified hyper enhancement (100%; located ileum 8/8). Median proximal bowel dilation 2.95 cm (2.5–4.1 cm). Less findings included: mesenteric adenopathy (50%; 4/8), increased edema/ascites (38%; 3/8), vascularity (25%; 2/8), colon inflammation (13%; 1/8), decreased fold pattern 1/8). No demonstrated penetrating (e.g., abscess, fistula). Conclusion cause overlapping etiologies such as NSAID that need be through multidisciplinary approach confirm