1981 Volume 23 Issue 11 Pages 1578-1584_1
A case of colonoileac Crohn's disease in a 21 years old male was experienced. This was a non-enterectomized case and the diagnosis was made by X-ray examnation, endoscopy and biopsy. In Crohn's disease, complication with rectal change is reportedly very uncommon, but minor changes such as aphthoid ulcer are often recognized and micro-granuloma is found in biopsy specimen of normal rectal mucosa. For detailed investigation of fine changes of the rectal mucosa in Crohn's disease, we closely examined the rectal mucosa of this case by usual magnifying endoscopy and by magnifying endoscopy after 0.2% methylene blue spray. The findings were reddening at the periphery of aphthoid ulcer indicating vascular proliferation and so-called worm-eaten appearance of papillae wherein several papillae and pits of epithelial tubule were destroyed. Serial sections of forceps biopsy specimen from this region revealed microgranuloma histologically and consequently discussion was made on the relation of these findings with the pathophysiology to see if they are specific to Crohn's disease.
