A Case of Multiple Simple Ulcer in Ileum Kept a Distance from IC Vule, with Massuve Bleeding

Takao Ichihara, Tomoaki Urakawa, Kiyoshi Uematsu

Department of Surgery, Kobe Rosai Hospital of the Labor Walfare Corporation

The patient was a 47-year-old man who had developed melena twice before, but the origin of the melena was not identified. On November 9, 1990, because of massive melena, colorectal endoscopy was carried out, revealing hemorrhagic ulcers in the cecum. The patient underwent ileocecal excision on December 26, 1990. During the operation, no lesion was found in the large intestine, but punched out ulcers were noted at three points of the small intestine. These ulcers were histologically classified as non-specific inflamed ulcers. This is a rare case in terms of the location and onset of this disease. However, a diagnosis of simple ulcers was made on the basis of the characteristic ulcers, and the absence of signs suggestive of Behçet's disease. Although the incidence of postoperative recurrence is high for simple ulcers, the present patient, who received prophylactic salazosulfapyridine therapy for 2 years after surgery, has not developed any sign of recurrence during the past 4 years. Thus, salazosulfapyridine was effective in preventing postoperative recurrence of this disease.

Key words
simple ulcer of ileum, massive bleeding, multiple simple ulcers

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

Accepted
January 11, 1995

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