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Small bowel inflammation in AOSD has been reported in association with Crohn\u2019s disease, coeliac disease and chronic intestinal pseudo-obstruction. We have here reported the first-time case of AOSD with small bowel involvement, presenting with chronic vomiting. Fluorodeoxyglucose total-body positron emission tomography\/CT showed high uptake of the duodenum and first jejunal loop. Faecal calprotectin increased. Duodenal histology revealed neutrophilic infiltrate among duodenal enterocytes and severe chronic lymphoplasmacellular infiltrate of the lamina propria. Vomiting disappeared when duodenojejunal inflammation was controlled by immunomodulatory treatments for AOSD, suggesting a possible causal relation between duodenojejunal inflammation and the symptom.<\/jats:p>","DOI":"10.1136\/bcr-2022-252345","type":"journal-article","created":{"date-parts":[[2023,2,9]],"date-time":"2023-02-09T10:05:31Z","timestamp":1675937131000},"page":"e252345","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Duodenojejunal inflammation causing chronic vomiting in adult-onset Still\u2019s disease"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2836-3068","authenticated-orcid":false,"given":"Cristina","family":"Manzotti","sequence":"first","affiliation":[{"name":"Dipartimento di Fisiopatologia Medico-chirurgica e dei Trapianti, Universit\u00e0 degli Studi di Milano, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Castellani","sequence":"additional","affiliation":[{"name":"Medicina Nucleare, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonella","family":"Murgo","sequence":"additional","affiliation":[{"name":"Divisione di Reumatologia Clinica, ASST Gaetano Pini, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guido","family":"Basilisco","sequence":"additional","affiliation":[{"name":"Gastroenterologia ed Endoscopia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,2,9]]},"reference":[{"key":"2025082701543446000_16.2.e252345.1","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-018-0081-x"},{"key":"2025082701543446000_16.2.e252345.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.crohns.2012.05.019"},{"key":"2025082701543446000_16.2.e252345.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.crohns.2010.02.010"},{"key":"2025082701543446000_16.2.e252345.4","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-002-1167-3"},{"key":"2025082701543446000_16.2.e252345.5","doi-asserted-by":"crossref","first-page":"414","DOI":"10.4103\/0019-5359.33191","article-title":"Celiac disease: association with adult-onset still\u2019s disease: apropos of a clinical case","volume":"61","author":"Kumar","year":"2007","journal-title":"Indian J Med Sci"},{"key":"2025082701543446000_16.2.e252345.6","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1002\/ccr3.3488","article-title":"A woman with adult-onset still\u2019s disease and acute intestinal pseudo-obstruction","volume":"9","author":"Hori","year":"2021","journal-title":"Clin Case Rep"},{"key":"2025082701543446000_16.2.e252345.7","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/S0399-8320(04)94925-1","article-title":"Still\u2019s disease and intestinal pseudo-obstruction","volume":"28","author":"El Younsi","year":"2004","journal-title":"Gastroenterol Clin Biol"},{"key":"2025082701543446000_16.2.e252345.8","doi-asserted-by":"publisher","DOI":"10.1159\/000447034"},{"key":"2025082701543446000_16.2.e252345.9","doi-asserted-by":"publisher","DOI":"10.1038\/s41395-018-0039-2"},{"key":"2025082701543446000_16.2.e252345.10","doi-asserted-by":"crossref","first-page":"35","DOI":"10.5858\/arpa.2016-0608-RA","article-title":"Celiac disease and other causes of duodenitis","volume":"142","author":"Owen","year":"2018","journal-title":"Arch Pathol Lab Med"},{"key":"2025082701543446000_16.2.e252345.11","doi-asserted-by":"publisher","DOI":"10.1080\/03009740701394005"},{"key":"2025082701543446000_16.2.e252345.12","first-page":"128","article-title":"Increase of duodenal and ileal mucosal cytotoxic lymphocytes in juvenile idiopathic arthritis","volume":"28","author":"Arvonen","year":"2010","journal-title":"Clin Exp Rheumatol"},{"key":"2025082701543446000_16.2.e252345.13","first-page":"2279","article-title":"The evolution of spondyloarthropathies in relation to gut histology. 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