A Case of Crohn's Colitis Which Was Difficult to Differentiate from Ulcerative Colitis Ichiro Hirata 1 , Chikao Shimamoto 1 , Osamu Saitoh 1 , Kouji Matsumoto 1 , Saburo Ohshiba 1 1The Second Department of Internal Medicine, Osaka Medical College Keyword: 非定型的潰瘍性大腸炎 , 大腸Crohn病 , 炎症性腸疾患 pp.707-712
Published Date 1990/6/25
DOI https://doi.org/10.11477/mf.1403110959
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 A 22-year-old male was admitted to our hospital with complaints of bloody stool and fever. Barium enema and colonoscopy at the first admission showed the disappearance of haustration, diffuse and fine mucosal granularity, erosions and small ulcers from the sigmoid colon to the transverse colon. The rectum seemed to be grossly normal. At that time, these findings were most suggestive of atypical ulcerative colitis (atrophic colitis type).

 His symptoms improved after the administration of SASP and corticosteroids. However, bloody stool and fever recurred three times and finally became refractory to the medications. Subtotal colectomy was then performed three years after the onset of symptoms.

 During his clinical course, repeat barium enema and colonoscopy revealed that longitudinal ulcers, eccentric deformity and narrowing developed gradually. These findings and macro- and microscopic findings of the resected specimen led to the final diagnosis of Crohn's colitis. The rectum was not involved throughout the course in this case.

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