Long-term Follow-up Study on Nonspecific Multiple Ulcer of the Small Intestine Toshiyuki Matsui 1 , Tsuneyoshi Yao 2 , Hidenobu Watanabe 3 , Akinori Iwashita 4 , Haruya Okabe 5 1The Second Department of Internal Medicine, Faculty of Medicine, Kyushu University 2Department of Internal Medicine, Fukuoka University Chikushi Hospital 3The First Department of Pathology, Niigata University School of Medicine 4Department of Pathology, Fukuoka University Chikushi Hospital 5Kitasato Health Service Center, Kitasato University pp.1157-1169
Published Date 1989/10/25
DOI https://doi.org/10.11477/mf.1403106592
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 Since the first case report on nonspecific multiple ulcer of the small intestine by Okabe et al in 1966, we experienced 5 more cases and followed-up these 9 cases for an average of 18 years.

 The HLA pattern in the 6 cases studied markedly differed from that in Crohn's disease.

 The long-term prognosis of this disease was divided into three categories according to social activity of the patients for the recent few years; good in 2 cases, fair in 4, and poor in 3. Recurrence was observed in all cases surgically treated. Frequency of surgery may thus affect the long-term prognosis.

 Various complications emerged during the follow-up period. Relatively frequent were peptic ulcer of the stomach and cholelithiasis. These complications developed only in the surgical cases suggesting the relationship to short bowel syndrome.

 In 3 of the 6 cases endoscopically examined, there were minute shallow ulcers and/or fine convergencies in the second portion of the duodenum. The configuration of these ulcers was quite similar to that found in the ileum. In addition, in 3 of the 7 cases who had barium enema examination, there were multiple circular ulcers with eccentric deformity in the transverse or descending colon, distal from the ileocolonic anastomosis.

 These findings highly suggest that nonspecific multiple ulcer of the small intestine is a digestive tract disease affecting not only the small intestine but also the duodenum and/or colon.

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