A case of recurrent simple ulcer after ileocecal resection for which endoscopic treatment with spraying of absolute ethanol was effective

Abstract

A 55-years-old male with simple ulcer resistant to sulfasalazopyrine and steroid therapy admitted to our hospital for lower abdominal pain. Ileocecal resection had been performed because of ileal perforation 9 years before. His symptom became a little better once after increase of prednisolone up to 40mg/day and total parenteral nutrition, however, oral diet induced worsening of abdominal pain again. Colonoscopy showed a deep and geographical ulcer at anastomotic site. Absolute ethanol spraying through endoscope at 20ml directly for the anastomotic ulcer was performed and pain was relieved a few days later. Colonoscopy after two weeks revealed that the size of the ulcer was remarkably reduced, and absolute ethanol spraying was repeated at 20ml. Lower abdominal pain has been relieved even after starting a meal. Absolute ethanol spraying through endoscope is easy to be performed and should be considered in the case of simple ulcer which is resistant to medical therapy.