Abstract A 57-year-old woman without comorbidities presented with severe abdominal pain, hematemesis, and melena. Contrast enhanced computed tomography demonstrated small bowel obstruction with two transition points in the proximal jejunum. Endoscopy revealed a circumferential jejunal ulcer larger than 5 cm with loss of vascular pattern, induration, whitish exudate, and contact bleeding. Segmental resection with side-to-side anastomosis was performed. Histopathology and immunohistochemistry confirmed cytomegalovirus infection. Intravenous ganciclovir was administered for 7 days, with a favorable clinical course and discharge in good condition. Cytomegalovirus should be considered in the differential diagnosis of acute intestinal obstruction even in the absence of immunosuppression. Early histologic confirmation and individualized treatment combining surgery and antiviral therapy are associated with favorable outcomes.
Torrente et al. (Sat,) studied this question.