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Suspected to be Intestinal Tuberculosis with Findings of Longitudinal Ulcers, Vasculitis and Granulomas, Report of a Case Shino Kamachi 1 , Akinori Iwashita 2 , Sumino Tsuda 1 1Department of Gastroenterology, Fukuoka University Chikushi Hospital Keyword: 腸結核 , 肉芽腫 , 血管炎 , 炎症性腸疾患 , 鑑別診断 pp.1207-1214
Published Date 2003/7/25
DOI https://doi.org/10.11477/mf.1403100797
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 A 69-year-old man was admitted to a hospital because of hematochezia. Colonic X-ray and colonoscopy revealed multiple ulcers in the ascending colon. The patients was referred to our hospital because of his constitutional resistance towards enteral nutrition therapy. At the colonic examination, lesions were mainly seen in the cecum and the ascending colon. The findings were : opening of the ileocecal valve, a mucosal atrophic zone and three longitudinal ulcers and fissuring ulcers. In the transverse colon, longitudinal ulcers were also found sporadically. Surgical right hemicolectomy was performed because of the resistance to nuturitional therapy. Histopathological findings of the resected specimens, showed that multiple ulcers from the cecum to the ascending colon, inflammation of whole layer, fissure, a relatively large non caseating granuloma with vasculitis around the arteries and veins. No recurrence of colitis has been found in this case for these nine years. Clinically and histopathologically, this case was highly suspected to have intestinal tuberculosis despite the findings of longitudinal ulcers, however, definite diagnosis of tuberculosis was not made because of negative bacterial existence.


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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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