From the Research
Jejunitis found incidentally on CT scan requires clinical correlation and further evaluation to determine its significance, prioritizing assessment for symptoms and laboratory tests to evaluate for systemic inflammation, as seen in a case of eosinophilic jejunitis presenting with acute abdomen and eosinophilic ascites 1. When evaluating jejunitis, it is essential to consider the potential causes, including Crohn's disease, celiac disease, infections, medication effects, or ischemia.
- Key steps in the evaluation process include:
- Assessing for symptoms such as abdominal pain, diarrhea, or weight loss that might be related to the jejunal inflammation
- Ordering laboratory tests, including complete blood count, comprehensive metabolic panel, C-reactive protein, and erythrocyte sedimentation rate, to evaluate for systemic inflammation
- Considering endoscopy with biopsy for symptomatic patients to determine the underlying cause
- Treatment depends on the specific etiology, and may include:
- Immunomodulators like azathioprine (50-150mg daily) or biologics such as adalimumab (initial 160mg followed by 80mg at week 2, then 40mg every other week) for Crohn's disease
- Strict gluten elimination for celiac disease
- Appropriate antimicrobial therapy for infectious causes
- The importance of further evaluation stems from the fact that jejunitis represents inflammation of the middle portion of the small intestine, which can significantly impact nutrient absorption and overall digestive health if left untreated, as highlighted in a study on incidental findings in blunt trauma patients 2.
- A recent study on eosinophilic jejunitis presenting as acute abdomen with eosinophilic ascites 1 demonstrates the need for careful evaluation and treatment of this condition, and another study on delayed-release oral mesalamine tablet mimicking a small jejunal gastrointestinal stromal tumor 3 highlights the importance of considering medication effects in the evaluation of jejunitis.