A CASE OF COLONIC CROHN'S DISEASE DIAGNOSED IN THE EARLY STAGE

Abstract

A case of colonic Crohn's disease in the early stage demonstrating only aphthoid ulcers and shallow discrete ulcers as the endoscopic findings was reported. The patient was a 38-year-old female who had been followed up for chronic constipation for one year and four months. She developed watery diarrhea associated with abdominal pain of nearly one month's duration and was admitted to our hospital for further evaluation of colonic lesions discovered by x-ray and endoscopic examinations. Colonoscopic examination revealed aphthoid ulcers and irregular-shaped shallow discrete ulcers scattering in the sigmoid colon up to the transverse colon, though rectum was intact. Barium enema examination demonstrated the granular mucosal lesions located only in the descending colon. Upper gastrointestinal tract and small intestine were normal. Colonic infectious diseases such as tuberculosis or amebic dysentery were ruled out, and colonic Crohn's disease was confirmed from demonstration of granuloma in the colonic biopsy specimen in addition to the endoscopic and X-ray findings. Colonic lesons were reversible and disappeared without any scar formation by the treatment of Metronidazole for about three months.