A Case of Crohn's Disease with a Giant Mass Extending from the Ileum to the Transverse Colon Being Surgically Resected

Akitoshi Kakisaka, Hidenori Karasaki, Yasuhiro Yamamoto, Kumiko Ito, Toru Kohon, Sinichi Kasai, Michio Mito, Yoshio Nakajima*, Yasuo Nakajima*

Second Department of Surgery, Asahikawa Medical College
*Department of Surgery, Nakajima Hospital

We experienced a patient with a giant inflammatory mass extending from the ileum to the transverse colon 11 years after the diagnosis of Crohn's disease, in whom abdominal pain did not improve, and surgery was performed under the diagnosis of peritonitis. The patient was a 39-year-old man who first presented to a local doctor with diarrhea and abdominal pain. Ilectomy was performed for ileus, and Crohn's disease was diagnosed. Temporary improvement was achieved by postoperative conservative treatment including an elemen-tal diet (ED), but after 5 years he was readmitted to the same hospital with nausea, vomiting, and fever. His symptoms were controlled by total perenteral nutrition (TPN) and ED, but remissions and exacerbations were repeated, and thegiant inflammatory mass formed. Right hemicolectomy and partial resection of the small intestine were performed afterhis admission to our department. Tumor size was 27.5×14.5×12 cm and the patient's postoperative recovery with conservative treatment was uneventfull.

Key words
Crohn's disease, giant inflammatory mass, elemental diet

Reprint requests
Akitoshi Kakisaka Second Department of Surgery, Asahikawa Medical College
JAPAN

Accepted
May 11, 1994

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