術後再発時に直腸にアフタ様病変を認めた回盲部単純性潰瘍の1例

Abstract

A 18-year-old female with recurrent simple ulcer, who had rectal aphthoid lesions following ileocecal resection, is reported. She was admitted because of right lower quadrant pain. Barium enema study and colonoscopy revealed 4 cm deep ulcer in the ileocecal region. Physical examination was unremarkable with the exception of the aphthous stomatitis and mild tenderness in the right lower quadrant. There were no genital ulcerations, eye lesions, and skin lesions. Needle reaction was negative. She was diagnosed as having a simple ulcer. She was treated with tocopherol nicotinate and salazosulfapyridine with no improvement. Ileocecal resection was performed. The ulcer was histopathologically diagnosed as active ulcer, and its depth was Ul IV. Five months after the operation, colonoscopy revealed two reccurent ulcers at the site of anastomosis, and several aphthoid lesions were first discovered in the rectum. Those aphthoid lesions were slightly elevated and about 2 mm in size. Three months later aphthoid lesions persisted, but follow-up colonoscopy has not revealed any aphthoid lesions since then. In this case of simple ulcer, aphthoid lesions may have appeared in association with recurrence after resection of the primary lesion.