A Case with Primary Nonspecific Ulcer of the Small Intestine Occurring in the Jejunum

Hidetaka Yamanaka, Mitsuo Nenohi*, Hiroyuki Katoh, Yoshihumi Ogura, Ryuji Mizumoto

First Department of Surgery, Mie University School of Medicine
*Department of Surgery, Sanagu Hospital

We report a case of primary non-specific ulcer of the small intestine complicated by perforation at the mesenteric site in the jejunum. A 67-year-old man was admitted to our clinic, complaining of severe lower abdominal pain. Chest and abdominal plain X-ray films showed free air in the bilateral subphrenic spaces. Therefore he underwent partial resection of the jejunum in an emergency operation, because intestinal perforation was observed in the distal jejunum at the mesenteric side, 100 cm anal to the Treize ligament. Pathological examination of the resected specimen revealed a primary nonspecific ulcer of the small intestine. This disease found in the jejunum is not common; only 15 cases including ours have been reported in Japan. Patients with jejunal ulcers were older than those with ileal ulcers. The nonspecific ulcer in the ileum usually occurred at the antimesenteric site, but the mesenteric site was slightly predominant in the jejunum. Some of the patients with perforated ulcers showed fetalism, and emergency diagnosis and surgery are warranted.

Key words
perforation of the jejunum, primary nonspecific ulcer of the small intestine

Reprint requests
Hidetaka Yamanaka First Department of Surgery, Mie University School of Medicine
2-174 Edobashi, Tsu, Mie, 514 JAPAN

Accepted
February 10, 1993

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