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A Case of Unclassified Intestinal Ulcer: Suspected Crohn's disease from its clinical course T. Fuchigami 1 , T. Yao 1 , H. Watanabe 2 , T. Yamamoto 1 , T. Omae 1 , M. Jimi 3 1The Second Department of Internal Medicine, Faculty of Medicine, Kyushu University 2The Second Department of Pathology, Faculty of Medicine, Kyushu University 3The First Department of Surgery, Faculty of Medicine, Kyushu University pp.1659-1666
Published Date 1978/12/25
DOI https://doi.org/10.11477/mf.1403107572
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 A 29-year-old male, complaining of diarrhea and abdominal pain, was admitted to this hospital. He had underwent intestinal resection due to intestinal ulcer eight years before. X-ray examination demonstrated an irregularly-shaped ulcer with fistulous formation at the stoma (ileocecostomy) and several ulcers at adjacent region both proximal and distal to the stoma. A second operation for intestinal resection was performed. Six ulcers were recognized at the region and the ulcers were oval or irregularly-shaped. Neither longitudinal ulcer nor cobblestone appearance was recognized. Histologically, five of the six ulcers were Ul-Ⅳ and the other was Ul-Ⅲ. Transmural inflammation and fissuring were recognized. However, granuloma was not found in the intestine or in lymphnodes. An ulcer recurred at the proximal site of the stoma a year after the second operation. The ulcer was irregularly shaped and had clearcut margin and folds convergence. The number of recurring ulcer increased thereafter, namely four ulcers which were recognized two and a half years after the second operation. All of them were oval or irregularly-shaped.

 The clinical course and histologically confirmed transmural inflammation and fissuring resembled those of Crohn's disease. However, the shape of the ulcers were quite different.

 It would be appropriate to group this patient with unclassified intestinal ulcer for the meantime.


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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