A CASE OF RECTAL CROHN'S DISEASE WITH CIRCULAR STRICTURE AND UNDERMINING ULCER

概要

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The patient was a 21-year-old man with a chief complaint of severe diarrhea on 19th of March in 1988. Barium enema and endoscopic examination revealed circular protruding lesions and undermining ulcer in the lower rectum. Rectal biopsy showed nonspecific inflammatory changes. There were no abnomalities in other parts of the GI tract. After that, the circular protruding lesions eventually changed to a cobblestone appearance and circular stricture developed. However, only nonspecific inflammatory changes were histopathologically detected by several biopsies. Perirectal abscess, perianal abscess and fisutula developed succesively and the rectal Crohn's decease was diagnosed finally. Because of difficulty of conservative treatment, sigmoid loop colostomy was performed. After salazosulf apyridine, betameth-asone, azathioprine and metronidazole were administered, fistula was closed and rectal stricture and undermining ulcer were improved. It was difficult to make a diagnosis for Crohn's disease by nonsurgical procedure in 21 cases which were reported in Japan. But recentry, there are increasing number of rectal Crohn's disease which responds to conservative therapy.
社団法人日本消化器内視鏡学会の論文