Celiac Disease Presenting as Idiopathic Terminal Ileum Obstruction

Abstract

Celiac disease is an inflammatory injury in the small bowel mucosal that occurs after ingestion of gluten. Here, is a case of idiopathic intestinal obstruction at the terminal ileum in a patient with celiac disease. A 34-year old Caucasian lady presented with terminal ileum obstruction and abdominal fluid collection. She was diagnosed with celiac disease based on the histological findings of focal villous atrophy, intraepithelial lymphocytic infiltrate and crypt hyperplasia with mitoses at the terminal ileal and jejenal biopsies, elevated anti-tissue transglutaminase antibody (Ab) Immunoglobulin (Ig) G, raised anti-tissue transglutaminase Ab IgA; and; positive HLA DQ2 gene. Her intestinal obstruction and abdominal fluid collection resolved with gluten free diet. In conclusion, intestinal obstruction at the terminal ileum and fluid collection in the abdomen can be a complication of celiac disease. A gluten free diet can lead to resolution of the intestinal obstruction and abdominal fluid collection in celiac disease.