Long Followed-up Crohn's Disease with Special Reference on Radiographic and Endoscopic Course of Recurrence, Report of a Case Y. Yamamoto 1 , T. Katsumata 1 , M. Takemiya 1 , H. Aiba 1 , M. Igarashi 1 1Department of Internal Medicine, School of Medicine, Kitasato University pp.327-332
Published Date 1984/3/25
DOI https://doi.org/10.11477/mf.1403106982
  • Abstract
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 A 14 year-old girl was admitted to Kitasato University Hospital with abdominal pain and perianal abscess on July 22,1975. Barium enema studies revealed cobblestone appearances in the ascending colon and skipped lesions in the distal ileum. Operation was performed on March 22,1976 because of its exacerbation, and its histological diagnosis was proved as Crohn's disease. In December 1976 recurrence at the anastomotic area was pointed out, and the second operation was undergone on July 7,1978. Macroscopically, the resected specimen exhibited an internal fistula and cobblestone appearances. On follow-up studies after the second operation, we could reveal the process of recurrence radiographically and endoscopically. In August 1979, granular mucosa and aphthoid ulcers were shown from the proximal ileum to the anastomotic area on x-ray films, and several small irregular and aphthoid ulcers on colonoscopy.

 In September 1979, these ulcers increased in size and number. In December 1979, they progressed to cobblestone appearances with large serpiginous or longitudinal ulcers and pseudopolyps. In March 1981, cobblestone appearances were extended from the anastomotic stricture to the distal colon. In June 1981, two months after medication of Metronidazole, most of these ulcers were healed to scars leaving only stenosis and pseudopolyps. And on follow-up study, we couldn't find active ulcers.

 The characteristic of this case-report is a close follow-up observation of recurrence after surgery.

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