A CASE REPORT OF A SIMPLE ULCER SHOWING UNUSUAL GROSS FINDINGS

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 61; no. 8; pp. 2108 - 2111
• Main Authors: SHIMADA, Hiroshi, NOMURA, Naoto, OKI, Shigeo, KANAYA, Koji, SUGITA, Akira
• Format: Journal Article
• Language: English
• Published: Japan Surgical Association 2000
• ISSN: 1345-2843; 1882-5133; 1882-5133
• DOI: 10.3919/jjsa.61.2108

Simple ulcer is recognized as punched-out ulcer of unknown origin in the ileocecal region. A 48-year-old man was admitted complaining of loss of appetite. Multiple ulcers were found in the ileocecal region through the transverse colon, and then a right hemicolectomy was performed because of repeated hematochezia. The gross findings showed multiple ulcers and inflammatory polyps which continued from the terminal ileum to the transverse colon, and a subserous fistula in the ileocecal region was found. The fistula extended overall the subserous layer from the ulcer bed in the terminal ileum to that in the ascending colon. The largest ulcer measured up to 10×5cm and was present on the ileocecal valve. Neither characteristics of Crohn's disease, nor any other specific inflammation appeared in the microscopic findings. We diagnosed this as a simple ulcer. Since a postoperative recurrence rate can be as high as 20%, a conservative therapy is often selected. In that case, the risk of profuse bleeding and also perforation should be cansidered. In conclusion, recurrence which is detected in an early stage, for example, an aphthous ulcer, can be cured by conservative therapy. For this reason, regular examination is very important.