Nonspecific Multiple Ulcers of the Small Intestine: Report of a case H. Ohgushi 1 , T. Yao 1 , T. Omae 1 , H. Watanabe 2 , K. Ohsato 3 1The Second Department of Internal Medicine, Fuculty of Medicine, Kyushu University 2The Second Department of Pathology, Fuculty of Medicine, Kyushu University 3The First Department of Surgery, Fuculty of Medicine, Kyushu University pp.393-398
Published Date 1977/3/25
DOI https://doi.org/10.11477/mf.1403112569
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 A 38-year-old female patient, complaining of anemia and edema, was admitted to Kyushu University Hospital in April 1974.

 She had hypochromic anemia and hypoproteinemia (TP: 4.6g/dl). Repeated stool examinations for occult blood were always strongly positive. Mantoux's reaction was questionably positive. X-ray examinations showed multiple focal rigidity with some areas of mild convergence of the mucosal folds in the lower part of small intestine.

 In July 1974, a partial resection of the ileum was performed under the endoscopic examination through ileostoma by confirming the location of the ulcers. The resected specimen showed 32 shallow annular ulcers without conspicuous contraction surrounded by almost normal mucosa.

 Histologically, all ulcers were shallow and revealed slight fibrosis and infiltration of lymphocytes and plasma cells localized in the ulcerated area. There were no granulomatous lesions with giant cells in the wall or regional lymphnodes, marked edema or fissure.

 Tissue fibrinolysis was examined by fibrin plate method. The fibrinolytic activity was increased in the ulcerated area, when compared with that in the normal area of ileum of the same patient. Since the occult blood of her stool became strongly positive again one month after the operation, administration of t-AM CHA was started but it was ineffective.

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