Abstract
A 12-year-old man who had been diagnosed as having a mild clinical stage of the segmental type ulcerative colitis (UC) was maintained with medical therapy. He was admitted complaining of epigastric pain and vomiting after four months. Endoscopic examination showed redness, small white erosions, a diffuse edematous mucosa-like crack with spontaneous bleeding in the entire stomach. Redness was seen in the duodenum, with small white erosions, edematous mucosa and swollen villi. Biopsied specimen revealed numerous inflammatory cells and neutrophils were obtained from a similar crypt abscess in the mucosa. Involvement of Helicobacter pylori and drugs could be ruled out in this case, so it was strongly suspected to be associated with UC. After administration of prednisolone and 5-aminosalicylic acid (750 mg , three times daily) ground to powder, his symptoms and endoscopic abnormalities all disappeared and the histological findings also significantly improved. There have been no reported cases of diffuse ulcerative upper-gastrointestinal mucosal inflammation in segmental type of UC except our case.
