Abstract
A 39-year-old man presented complaining of diahrrea and bloody stool. Colonoscopy and barium enema showed continuous tiny ulcerations in the whole rectum and sigmoid colon. Endoscopic biopsy specimen showed infiltration of inflammatory cells and crypt abscess in the mucosa of rectum. We diagnosed the patient as left side ulcerative colitis. By the colonoscopy and barium studies, the oral side from sigmoid colon appeared to be normal except for the appendix in which the orifice elevated like a whirlpool. After a treatment with SASP (salazosulfapyridine), the left side of the colon improved, but the orifice of the appendix became more erosive and edematous. The appendix could not be visualized by barium enema. Malignant tumor in the appendix could not be ruled out. The resected appendix showed severe erosion but no malignancy. The diagnosis of this case was appendicitis associated with ulcerative colitis, coincident so-called 'ulcerative appendicitis'. This is the second operated case in Japan.
