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Sarcoidosis causing duodenal obstruction

Case report and review of gastrointestinal manifestations

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Conclusions

We present an unusual case of sarcoidosis in which the clinical presentation is best explained by an inflammatory mass in the region of the ampulla of Vater causing obstruction of the bile duct and pancreatic duct as well as intermittent duodenal obstruction. It is clear from previous reports that gastrointestinal exacerbations of sarcoidosis may occur during quiescent pulmonary disease. We are confident of the diagnosis because (1) the patient had a well-documented history of systemic sarcoidosis; (2) the obstruction responded to high-dose steroids promptly on two separate occasions; (3) biopsy of peripancreatic lymph nodes in the inflammatory mass was consistent with sarcoidosis; and (4) there was no clinical or radiographic evidence for Crohn's disease or any other granulomatous disorder. Our report indicates that small bowel obstruction must be added to the list of rare intra-abdominal complications of sarcoidosis.

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Stampfl, D.A., Grimm, I.S., Barbot, D.J. et al. Sarcoidosis causing duodenal obstruction. Digest Dis Sci 35, 526–532 (1990). https://doi.org/10.1007/BF01536930

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