Carcinoma of the Ileum Associated with Crohn's Disease

Ryusei Matsuyama, Yasuhiro Sumi, Takuya Yamada, Katsutoshi Murase, Naomasa Yoshida and Yutaka Ozeki

Department of Surgery, Tosei National Hospital

We report a case of carcinoma of the ileum associated with Crohn's disease. A 59-year-old man had a checkup in his local hospital for abdominal pain. A long intestinal tube contrast study was performed, resulting in a diagnosis of ileus with a final diagnosis of Crohn's disease. Because the ileus symptom recurred afterwards and did not improve, surgical removal of a stricture 30 cm from the distal end of the ileum was performed. Histologic examination of the resected specimen demonstrated a moderately differentiated adenocarcinoma and there was cancer in the surgical stump and exfoliation sides. The patient therefore consulted our hospital for the purpose of an additional resection. We diagnosed the condition as an ileum carcinoma complicated with Crohn's disease, and performed a right hemicolectomy with partial resection of the wall of the bladder. An indistinct nodular lesion was recognized in the border near the anastomosis of the first operation. Histologic examination of the background mucosa demonstrated a moderately differentiated adenocarcinoma and Crohn's disease in the process of repair. The possibility of carcinoma should be taken into consideration for an extensive stenosis of the small intestine in Crohn's disease.

Key words
Crohn's disease, ileus, carcinoma of the ileum

Reprint requests
Ryusei Matsuyama Department of Surgery, Tosei National Hospital
762-1 Nagasawa, Shimizu-cho, Sunto-gun, Shizuoka, 411-8611 JAPAN

Accepted
October 29, 2003

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