A Case of Small Bowel Carcinoma with Crohn's Disease

Koya Hida, Junichiro Kawamura, Satoshi Nagayama, Takaki Sakurai¹⁾, Yoshinori Mizumoto²⁾ and Yoshiharu Sakai

Department of Surgery and Department of Pathology, Graduate School of Medicine¹⁾, Kyoto University
Department of Gastroenterology, National Hospital Organization Kyoto Medical Center²⁾

We report a case of Crohn's disease associated with small bowel carcinoma that developed in a 49-year-old Japanese man. He was diagnosed to have Crohn's disease at the age of 22 years, and the symptoms resolved following treatment with salazosulfapyridine at that time. At the age of 36 years, he had an operation because of small bowel perforation. Since then, he has had repeated episodes of bowel obstruction and balloon dilatation. Because the obstructive symptoms were persistent, he was admitted for a second operation to our hospital. There were many obstructed segments, therefore, small-bowel resection up to the terminal ileum was performed. Pathologic examination of the resected specimen revealed dysplasia spreading over a length of 90 mm with focal cancer (T2 N0 M0). In Japan, the number of Crohn's disease patients continues to grow yearly, and reports of small bowel carcinoma in association with Crohn's disease have also been increasing. In cases of Crohn's disease with significant obstruction, the probability of carcinoma should be considered.

Key words
Crohn's disease, carcinoma, small bowel

Reprint requests
Koya Hida Department of Surgery, Graduate School of Medicine, Kyoto University
54 Shogoinkawahara-cho, Sakyo-ku, Kyoto, 606-8507 JAPAN

Accepted
September 26, 2007

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