④回盲部非特異性潰瘍の1例

Nonspecific Ulcers of the Ileocecal Region; A case report

　腸における原因不明の潰瘍性病変として潰瘍性大腸炎，クローン病，いわゆる非特異性多発性小腸潰瘍などとともに単純性または非特異性潰瘍があげられるが，われわれは慢性の経過をとり，術前クローン病あるいは腸結核との鑑別が問題となった回盲部と回腸に3コの潰瘍が見られた非特異性潰瘍症例を経験したので報告する．

　A 51 years old man was admitted to our hospital, complaining of right lower quadrant mass and vomiting. Since 4 months ago, he had been treated at another hospital under the diagnosis of Crohn's disease or colonic tuberculosis.

　On physical examination, he was noted to have egg-sized mass with a smooth surface and slight tenderness in the ileocecal region. Barium enema and small bowel follow-through studies revealed a relatively deep ulcer in the ileocecal region and two ulcers in the ileum with mucosal convergence. Endoscopic examination showed irregular polypoid mass covered with reddish mucosa in the cecum.

　Ileocolostomy was performed with clinical diagnosis of Crohn's disease. The diagnosis of nonspecific ulcers of the bowel was determined histologically, two of three ulcers were Ul-Ⅳ and other was Ul-Ⅲ, containing markedely hyperplastic lymph follicles.

　This case was difficult to be differentiated from Crohn's disease.