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A Case of Mixed Form of Granulomatous Ileocolitis and Ulcerative Colitis S. Kawano 1 , T. Moriuchi 1 , K. Tamura 1 , O. Fukui 1 1Department of Gastroenterology, Osaka National Hospital pp.1085-1090
Published Date 1975/8/25
DOI https://doi.org/10.11477/mf.1403112350
  • Abstract
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 A twenty five years old man was admitted to Sumitomo Besshi Hospital in June 1969, with one year history of watery diarrhea, abdominal pain, weight loss and weakness. Surgical treatment was recommended after barium enema examination which was suggestive of granulomatous ileocolitis. A right hemicolectomy and ileotransversostomy were performed in October 1970. He was readmitted in February 1972, because of recurrence of the disease in the remaining colon. His course was complicated by uveitis of the left eye which disappeared after left hemicolectomy and ileoproctostomy performed in June 1973.

 The disease is still present in the rectum, associated with perianal fistula.

 X-ray examination: Barium enema at first admission showed diffuse involvement of the terminal ileum and right half of the colon, associated with skip lesion in the mid descending colon. Barium enema at second admission revealed that whole of the remaining colon was involved. On both examinations rigidity of the wall and pseudopolypoid mucosal change were marked. No abnormalities were found in the rectum.

 Pathological findings: Grossly serosa and mesenterium were edematous and multiple longitudinal ulcers were seen in the mucosa. Microscopically, the inflammatory component involved all layers of the bowel wall. Aggregation of small round cells, lymphoid follicles and noncaseating sarcoid-like granulomas were present in variable density not only in the submucosa but also in the lamina propria, subserosa, and to much lesser extent in the muscularis propria.

 In 1972 Lockhart-Mummery described the definition of Crohn's disease of large intestine through his experience for twenty years, and many papers about the disease have been reported after that. But the relationship between this disease and ulcerative colitis remains unknown. Meanwhile since our case has both the features of Crohn's disease of the large intestine and ulcerative colitis, we had to classify it as a mixed type between the two. We must be careful at present in the diagnosis of ulcerative diseases of the colon such as ours. We expect to make more definite diagnosis in near future.


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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