Simple Ulcer of the Ileum at 40 cm Oral from the Bauhin's Valve, Report of a Case Kiyoshi Ashida 1 , Hogen Tei 1 , Ichiro Hirata 1 , Saburo Ohshiba 1 , Kunio Okajima 2 1The Second Department of Internal Medicine, Osaka Medical College 2Department of Surgery, Osaka Medical College pp.1145-1149
Published Date 1989/10/25
DOI https://doi.org/10.11477/mf.1403106589
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 The patient was a 36-year-old male with a complaint of continuous dull pain under the umbilicus for the last 3 months. He had undergone an upper GI series, a barium enema and an abdominal US at another hospital and was told that no abnormal findings were noted. He was referred to our hospital because of increasing abdominal pain. A small intestinal roentgenography at our hospital demonstrated a severe stenosis, 2.5 cm in length, at about 40 cm oral from the Bauhin's valve. Coexisting longitudinal ulcer and marginal elevations were also suspected (Figs. 1-3).

 Examination of the resected specimen showed a deep and clearly demarcated ulcer, 3.5×2.0 cm in size, on the mesenteric side with marginal elevations but without a longitudinal ulcer (Fig. 5). Histologically, the depth of this ulcer was Ul-Ⅳ and the small intestinal wall was markedly thickened because of the proliferation of fibrous tissue (Fig. 6). Based on these findings this lesion was diagnosed to be a simple ulcer in the ileum.

 It would be relatively unusual that a simple ulcer occurs in the ileum. Therefore, it was necessary to differentiate it from adenocarcinoma or Crohn's disease before the operation.

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