A 30-year-old male arrived at our hospital with fever, bloody stools (5-6 times/day), abdominal pain, and chest tightness which had lasted for 20 days. He was admitted to our hospital on the same day as his blood test revealed high inflammation and CT showed thickening of the intestinal wall. Colonoscopy revealed Matts classification grade 3 ulcerative colitis (UC) of the whole colon. Esophagogastroduodenoscopy (EGD) revealed punched-out ulcers in the mid intrathoracic esophagus, but pathological examination revealed only nonspecific inflammatory cell infiltration, with no granuloma or cellular atypia, and immunostaining was negative for CMV, HSV-1, and HSV-2. Mesalazine 4800 mg was started for UC, and subjective symptoms improved. UC was relieved by repeat colonoscopies, and the esophageal ulcers were relieved by EGD. The esophageal ulcers improved with UC only with 5-ASA preparations, suggesting a relationship with UC.
