Abstract
We report a case of carcinoma of the ileum associated with Crohn's disease. A 59-year-old man had a checkup in his local hospital for abdominal pain. A long intestinal tube contrast study was performed, resulting in a diagnosis of ileus with a final diagnosis of Crohn's disease. Because the ileus symptom recurred afterwards and did not improve, surgical removal of a stricture 30cm from the distal end of the ileum was performed. Histologic examination of the resected specimen demonstrated a moderately differentiated adenocarcinoma and there was cancer in the surgical stump and exfoliation sides. The patient therefore consulted our hospital for the purpose of an additional resection. We diagnosed the condition as an ileum carcinoma complicated with Crohn's disease, and performed a right hemicolectomy with partial resection of the wall of the bladder. An indistinct nodular lesion was recognized in the border near the anastomosis of the first operation. Histologic examination of the background mucosa demonstrated a moderately differentiated adenocarcinoma and Crohn's disease in the process of repair. The possibility of carcinoma should be taken into consideration for an extensive stenosis of the small intestine in Crohn's disease.
