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Multiple Aphthoid Ulcers of Gastrointestinal Tract-A case report of Crohn's disease Masahiko Hirakawa 1 , Mitsuo Iida 1 , Takumi Nanbu 1 , Akihiro Shigematsu 2 , Shigekazu Kuroiwa 2 , Masatoshi Fujishima 1 1The Second Department of Internal Medicine, Faculty of Medicine, Kyushu University 2The Second Department of Pathology, Faculty of Medicine, Kyushu University pp.1015-1019
Published Date 1986/9/25
DOI https://doi.org/10.11477/mf.1403110237
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 A 29 year-old man visited our hospital complaning of diarrhea, abdominal pain and body weight loss. Laboratory examination revealed leucocytosis, positive C-reactive protein, and elevated erythrocyte sedimen-tation rate. On gastrointestinal roentgenographies and endoscopic examinations, multiple aphthoid ulcers were found in the prepyloric region of the stomach, duodenum, small intestine and colon. Histological examination of the biopsy specimens from the sigmoid colon and stomach showed non-caseating epithelioid cell granulomas with Langhans giant cells, suggesting Crohn's disease. The patient was treated primarily with elemental diet alimentation for one month, and this resulted in a remission of symptoms and a resolution or healing of aphthoid ulcers. One year later, he underwent fistulectomy for painful peri-anal fistulas. On the follow-up gastrointestinal roentgenographies and endoscopic examinations, multiple aphthoid ulcers were found again in the duodenum and small intestine. This case was considered to be an unusual type of Crohn's disease, because the only gastrointestinal lesions recognized were aphthoid ulcers.


Copyright © 1986, 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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