③回腸末端における非特異性（単純性）孤立性潰瘍

A Case Report of Nonspecific (Simple) Solitary Ulcer of the Terminal Ileum

　1年前に右下腹部痛のため開腹術を受け，回腸末端の急性炎症を指摘されたことがある非特異性（単純性）孤立性腸潰瘍を経験したので報告する．

症　例

　患　者：34歳　男性

　主　訴：右下腹部痛

　既往歴：1977年6月試験開腹術，1978年3月扁桃腺摘出術を受けた．

　現病歴：1977年4月ごろから時折右下腹部痛を訴え近医で急性虫垂炎の疑いで開腹されたが，その回腸末端に発赤，腫脹を指摘されただけで手術を終わった．同年8月ごろには疼痛は消失したが，1978年3月ごろから再び右下腹部痛をきたし，同年5月8日当科へ入院した．

　A 34-year-old man was admitted with a complaint of right lower quadrant pain. On physical examination, he was noted to have tenderness in the ileocecal region. Barium enema and small bowel follow-through studies showed a solitary ulcer in the terminal ileum. The resected specimen demonstrated a solitary oval shaped ulcer on the antimesenteric border of the terminal ileum. Microscopic finding showed an open ulcer (Ul-Ⅳ), which was composed of cellular exudates, fibrosis and nonspecific inflammatory cell infiltration accompanied by lymphoid hyperplasia.

　No granuloma was present. General macroscopic and microscopic appearances were inconsistent with those of Crohn's disease, tuberculosis or nonspecific multiple ulcers of the small intestine. This case, therefore was diagnosed as nonspecific (simple) solitary ulcer of the terminal ileum.