THE PROTEAN nature of disseminated scleroderma has been thoroughly documented.* In the discussion of alimentary tract involvement, the esophagus has been the focus of most attention. The changes in the remainder of the gastrointestinal tract have not been adequately stressed or completely described.
Review of the literature indicates that at least 21 cases with either roentgenologic or pathologic evidence of intestinal involvement by scleroderma have been recorded in sufficient detail to be analyzed.f Although 13 of these cases were subjected to autopsy, there have been few detailed descriptions of the histologic changes in the small intestine and even fewer adequate illustrations. On the whole, the findings were said to consist of replacement by dense collagen of the submucosa and at times of the muscularis, associated with atrophy and degenerative changes, particularly of the smooth muscle. The onset of the disease occurred prior to the age of 40 in about two-thirds