Japanese

Segmental Ulcerative Colitis Diagnosed by Follow-up Study, Report of a Case T. Sezaki 1 , A. Kariya 1 , M. Hayashi 1 , S. Mayama 1 , M. Haraikawa 1 1Department of Diagnostic Radiology, Chiba Cancer Center Hospital pp.309-312
Published Date 1984/3/25
DOI https://doi.org/10.11477/mf.1403106978
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 A 23 year-old man was admitted to our hospital for investigation and treatments, complaining of mucoid bloody diarrhea and low grade fever.

 On physical examination, he was noted to have mild tenderness in the ileo-cecal region and midlower abdomen. Lobaratory examination disclosed C reactive protein of three positive and erythrocyte sedimentation rate of 34 mm per hour. Barium enema study showed following findings: Irregularly-shaped shallow ulcers and narrowing in the sigmoid colon, linear-like ulcer and inflammatory polyps in the proximal descending colon, and irregular margin and multiple barium flecks from proximal ascending colon to cecum. The intervening colon among the lesions were seemed to be almost normal. The terminal ileum was not involved.

 Total colectomy with partial rectal resection and ileorectostomy were accordingly performed.

 Grossly, circumscribed and continuous lesions with irregularly-shaped shallow punched-out ulcers and erosions were recognized in skipping at the following areas; from cecum to proximal ascending colon (8 cm in length), proximal descending colon (15 cm in length), and from whole sigmoid colon to rectum (35 cm in length). Neither stricture formation nor fistula formation was recognized, and neither longitudinal ulcer nor cobblestone appearance was recognized.

 Histologically, the ulcers were Ul-Ⅰ~Ⅱ, and multiple crypt abscesses were recognized in the colonic glands. Neither transmural inflammation nor fissuring ulcer was recognized. Caseating granuloma was not also found in the intestine and regional lymph nodes. These macroscopic and microscopic findings wese compatible with “segmental ulcerative colitis”.

 Now four years have passed since the operation, and he is completely free of preoperative symptoms.


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

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