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A New Proposal on Ulcerative Lesions of the Small Intestine: Centering on So-called “Ulcerative, Non. proliferative Disease of the Small Intestine T. Yao 1 , T. Fuchigami 1 , M. Sakimura 2 , K. Okabe 3 12 nd Dept. of Int. Med., Faculty of Med., Kyushu Univ. 2Sakimura Hospital 3Dept. of Int. Med., Kitasato Univ. pp.1615-1619
Published Date 1972/12/25
DOI https://doi.org/10.11477/mf.1403108985
  • Abstract
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 Ulcerative, non-proliferative disease of the intestine is clinically seen in young adults, and its cardinal symptoms include persistent occult blood in the stool of many years' duration, marked anemia and hypoproteinemia due to the covert bleeding. Usually it is unaccompanied with diarrhea, fever or malabsorption. Relapse is most common with re-bleeding even after surgical correction, but through its long lasting course no perforation, fistulization, intestinal obstruction or abscess is to be seen. Medical management including steroid hormones fails to alter its course.

 Basic macroscopical pictures of ulcerative, nonproliferative disease of the intestine are multiple shallow ulcers developing crosswise or obliquely on the intestinal mucosa. The terminal ileum remains free from ulceration. Its microscopic features are multiple shallow ulcers mostly confined within the submucosa. Accompanying inflammaion is also of slight degree. Features seen in Crohn's disease, such as severe edema, thick proliferation of connective tissue and granuloma, can not be observed.

 It is shown here that ulcerative, non-proliferative disease of the intestine differs, both in clinical pictures and in tissue reaction, from Crohn's disease. The present status of the diagnosis of Crohn's disease has also been described, which is at present made solely after exclusion of other specific inflammations of the intestine. We hereby propose that non-specific ulcers of the small intesitne be classified as follows: ―

Non-specific ulcers of the small intestine

 1. Due to known causes: enteric coated tablets of KCL, irradiation therapy, etc.

 2. Intestinal ulceration as a regional manifestation of systemic diseases: collagen diseases, intestinal Behçet, uremia, etc.

 3. Non-specific ulcers of the small intestine in a narrow sense (Primary non-specific ulcers of the small intestine)

  1) Crohn's disease

  2) Ulcerative, non-proliferative disease of the small intestine

  3) Chronic ulcerative jejunoileitis

  4) Simple ulcer

  5) Others


Copyright © 1972, 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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