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Inflammatory Diseases of the Intestine: An analysis of 1200 surgical materials K. Saito 1 , A. Takahashi 1 , T. Machida 1 , Y. Kato 2 , I. Kino 3 1Department of Pathology, Jichi Medical School 2Department of Pathology, Tokyo University 3Department of Pathology, Hamamatsu Medical School pp.1053-1061
Published Date 1975/8/25
DOI https://doi.org/10.11477/mf.1403112346
  • Abstract
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 All of the resected intestinal segments excluding duodenum, examined at the Section of Pathology, Tokyo University Hospital from 1955 to 1974, Hitachi General Hospital from 1960 to 1974 and Jichi Medical School Hospital in 1974 were reviewed.

 There were only 12 cases of Crohn's disease characterised by transmural inflammation, fissuring ulcers and non-caseating epitheloid cell granulomata. Ten cases were male and 2 cases were female. The age of the patients at the time of operation was from 16 years old to 34 years (average 25 years). Sites of the lesions were as follow: Terminal ileum, 3 cases; terminal ileum, caecum and ascending colon, 2 cases; caecum, 1 case; ascending colon, 3 cases; entire colon, 1 case; rectum, 1 case; terminal ileum, entire colon, and duodenum, 1 case, which was the first case of histologically confirmed duodenal Crohn's disease in Japan. Epitheloid cell granuloma was identified in 10 cases. Appendiceal lesion was ascertained in 3 cases. Anal lesion was described in 2 cases. Intestinal Behçet had been suspected in a case of rectal Crohn's disease because of aphthoid lesions of the mouth and perianal ulcer.

 Most cases diagnosed as ulcerative colitis have been treated by medications. Nineteen cases were surgically treated in the same period. Nine cases were male and 10 cases were female. The age of the patients at the time of first operation was from 18 years to 45 years (average 27 years).

 Thirty four cases of intestinal tuberculosis were resected in the same period. Of these, 16 cases had ileocaecal lesions, 12 cases had lesions in small intestine other than terminal ileum. Six cases had colonic lesions. The average age at the time of resection was 36 years.

 Special interest was paid to solitary, large, deep ulcer of the caecun involing the Bauhin's valve, often called as “non-specific inflammatory tumor of the colon” or “non-specific ulcer of the colon” in Japan. The large ulcer with deep undermining was usually located in the mesenteric side of the caecum and penetration of the entire wall was the rule. Follicular lymphocytic aggregations were often found around the ulcer. The entire intestinal wall near the ulcer was normal and no epitheloid cell granulomata was discovered. The average age of the patients was 27 years. Two cases over the age of 50 were male and we could not completely exclude postappendectomy complication. Twelve cases were under the age of 35, of which 3 cases were male and 9 cases were female. Recurrence of ulcer at the site of anastomosis was documented in 2 cases.

 No case consistent “ulcerative, non-proliferative disease of the small intestine (Okabe, Sakimura)” was found in our materials. Three cases over the age of 50 revealed multiple ulcer scars of the small intestine which resembled healed intestinal tuberculosis although no evidence was identified as such at the time of operation.


Copyright © 1975, 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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