Abstract
An 85-year-old woman admitted to our hospital with nausea and persistent fever, and had a sudden onset of anal bleeding 8 days after the admission. The colonoscopy revealed a well -demarcated open (punched out) ulcer in the sigmoid colon and ischemic mucosal changes in the adjacent colonic segment. Because of the resistance to the conservative therapy, she underwent sigmoidectomy on day 15 after the admission. "The histological finding was compatible with a simple ulcer, characterized by a deep ulceration accompanied with nonspecific inflammation. Although the simple ulcer is a well-known disorder occurring in the ileo-cecal region, the disease in the sigmoid colon is rare, and to our knowledge, only 7 cases have been published in the Japanese literature. The etiology of this disease, occurring preferentially in the agedpatients (26 to 85) and not accompanied with Behcet disease, suggests its unique pathogenesis. Early clinical suspicion combined with surgical management is mandatory in preventing serious morbidity of perforation or penetration accompanied with simple ulceration in the sigmoid colon.
