PERFORATION OF SIMPLE ULCER OF THE SMALL INTESTINE ASSOCIATED WITH ILEUS DUE TO A CANCER OF THE DESCENDING COLON-A CASE REPORT-

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  • 下行結腸癌によるイレウスに合併した単純性小腸潰瘍穿孔の1例

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Abstract

Simple ulcer of the small intestine is rare and has not been established as a single disease entity, though it has been increasingly reported. Here, we present a case of socalled simple ulcer of the small intestine which was not typical but could be classified into the category. A 49-year-old woman experienced sudden onset of abdominal pain while she was in the hospital for examination of ileus due to a cancer of the descending colon. The findings of physical examination, chest X-ray and computed tomography suggested perforation of the small intestine, and an emergency operation was performed. The operative findings showed many reddish areas with white coating on the ileum and one of these spots was perforated. A portion of the small intestine by 120cm including these area was excised and simultaneously a descending colectomy with transverse colostomy was performed. Twenty demarcated oval ulcers forming a line were visible on the small intestine opposite to the mesoileum in the resected specimen. At present this case is permitted to be categorized as simple ulcer of the small intestine. We think, however, that it is likely to be classified into another category of the disease by further accumulation of similar case reports, because the number and arrangement of ulcers in this case were far distinctive.

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