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A Case Report of Recurrent Crohn's Disease with Internal Fistulae Formation M. Kitagawa 1 , K. Tsune 1 , S. Waki 1 , T. Murohisa 1 , H. Ôkubo 2 1Dept. of Gastroenterology, Hamamatsu Medical Center 2Dept. of Pathology, Hamamatsu Medical Center pp.395-401
Published Date 1978/3/25
DOI https://doi.org/10.11477/mf.1403107252
  • Abstract
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 A 23-year-old-male was admitted to our hospital in Sept. 1972, because of severe abdominal pain. Diagnosed as small intestinal obstruction, immediate emergency operation was recomended. Then macroscopical and histological diagnoses were probably Crohn's disease of small intestine.

 He was readmitted to our hospital in Sept. 1976, because of abdominal pain, abdominal fullness, anorexia, diarrhea, anemia and fever.

 X-ray examination of small intestine with double contrast method showed skip lesions and longitudinal ulcer with pseudodiverticula in jejunum and internal fistulae and longitudinal ulcer in ileum. There was no remarkable change in large intestine by barium enema. Partial jejunoileotomy was again performed, diagnosed as Crohn's disease. Jejunum was resected about 25 cm in length and ileum, about 45 cm in length.

 Macroscopical findings showed three small ulcers and longitudinal ulcer in jejunum and internal fistulae and longitudinal ulcer in ileum. All of these ulcers were located just beneath the attachment of the mesentery. Histological findings showed intramural inflammation, sarcoid-like granuloma in the subserosal layer and fissuring ulcers. From these findings, Crohn's disease of small intestine pattern was diagnosed.


Copyright © 1978, Igaku-Shoin Ltd. All rights reserved.

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

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