A Case of Recurrent Simple Ulcer in Ileocecal Region with Internal-fistula between Small Intestine and Colon

Takao Ichihara, Etsuji Shimada, Tomoaki Urakawa, Takashi Ueda, Yasuhisa Hasegawa, Junsuke Nishikawa, Takashi Kamigaki, Kiyoshi Uematsu, Kazuhiko Iwagoshi*, Takeshi Ishida**

Department of Surgery, Gastroenterology*, Kobe Rosai Hospital of the Labor Walfare Corporation
**Department of Surgery, Yodogawa Christian Hospital

The patient was a 41-year-old man who visited our clinic because of right lower abdominal pain with slight fever. X-ray and endoscopic study revealed eight undermining ulcers with a clear elevated border near the ileocecal valve and in the terminal ileum. The two ulcers nearest the ileocecal valve formed a fistula on the stoma. Ileocecal excision and partial excision of the small intestine was performed, and the patient was diagnosed as simple ileocecal ulcer. Eight months postoperatively the ulcer recurred in the anastomotic area on the anal side with an internal fistula formed with the small intestine approximately 60 cm from the anastomotic site. A second operation was then performed. In this disease, unlike Crohn's disease, fistula formation is rare. There have been only a few reports in which a patient with simple ileocecal ulcer showed repeated internal fistula formation. This patient exhibited a very rare clinical course.

Key words
simpke ulcer, recurrent simple ulcer, internal-fistula

Reprint requests
Takao Ichihara Department of Surgery, Kobe Rosai Hospital of the Walfer Corporation
4-1-23 Kagoikedori, Chuo-ku, Kobe, 651 JAPAN

Accepted
December 9, 1992

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