# Cytomegalovirus enteritis as an unusual cause of small bowel obstruction in an immunocompetent woman: a case report

## TL;DR

A 57-year-old woman with no immune issues had severe stomach problems caused by a rare virus, which was successfully treated with surgery and medication.

## Contribution

Highlights cytomegalovirus as a rare cause of small bowel obstruction in immunocompetent individuals.

## Key findings

- Cytomegalovirus enteritis was confirmed as the cause of small bowel obstruction in an immunocompetent patient.
- Combining surgery and antiviral therapy led to a favorable clinical outcome.
- Histopathology and immunohistochemistry were crucial for accurate diagnosis.

## 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.