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Non-Surgically Diagnosed Rectal Crohn's Disease, Report of a Case Nobuyasu Kano 1 , Shoji Uji 1 , Tsutomu Ishikawa 2 , Hidetake Doi 2 , Kuniyasu Shimokawa 3 1The First Department of Surgery, Gifu University School of Medicine 2Department of Radiology, Gifu University School of Medicine 3Department of Laboratory Medicine, Gifu University School of Medicine pp.455-460
Published Date 1988/4/25
DOI https://doi.org/10.11477/mf.1403108110
  • Abstract
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 A 37-year-old male was admitted to the hospital with complaints of anal pain and difficulty in defecation. Barium enema and endoscopic examinations revealed a remarkable stricture with cobblestone appearance and longitudinal ulcers in the rectum.

 Histopathologically, a non-caseating granuloma was found in the specimen including the entire layer of the rectum. Other parts of gastrointestinal tract were unremarkable by x-ray and endoscopy. These findings led to a diagnosis of rectal Crohn's disease.

 Rectal Crohn's disease is rare in Japan. During the past 18 years only eight cases including ours have been reported. Six cases of these were diagnosed as such only after resection or amputation of the rectum. Only two of eight have been comfirmed without operation. The mean age of all reported cases in Japan was 32.8, while it was 53.6±18 in the report of Williams et al.

 Differentiating rectal Crohn's disease from rectal carcinoma, tuberculosis, solitary ulcer syndrome and colitis cystica profunda is important, especially from tuberculosis in the rectum. Detailed histopathological study of full layer biopsy specimen as well as sophisticated x-ray and endoscopic examinations is essential to improve its diagnostic accuracy and to avoid unnecessary surgical intervention.


Copyright © 1988, 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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