A Case of Simple Ulcer was associated with HLA B51 Positive in Elderly Female Patient

Yoshimi Hirohashi, Yorikazu Ohtsuka and Katsuhiko Hidaka

Department of Surgery, Takeo City Hospital

A 79-year-old woman admitted with suspected bowel obstruction had a past history of oral aphta 2 months earlier. After temporary remission, symptoms recurred, necessitating surgery. Operative findings showed marked wall thickness and redness of the terminal ileum, necessitating ileocecal resection. The resected specimen showed a large punched-out ulcer on the ileocecal valve and 3 small ulcers on the terminal ileum. Histologically, the ulcer was nonspecific and reached the subserosal layer. In this case, it was very difficult to differentiate between Behçet's disease and simple ulcer due to the presence of oral aphta and positive HLA B51. Finally, a diagnosis of simple ulcer was made bared on the absence of other specific signs of Behçet's disease except for oral aphta and positive HLA B51. Simple ulcer should thus be kept in mind as a differential diagnosis, even in an elderly patient.

Key words
simple ulcer, HLA B51, elderly patient

Reprint requests
Yoshimi Hirohashi Department of Surgery, Takeo City Hospital 11083 Oaza Tomioka, Takeo-machi, Takeo, 843-0024 JAPAN

Accepted
February 26, 2003

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