A case of non-specific ulceration in small and large intestine

Abstract

A 66-year-old man was admitted to our hospital because of melena, anemia and high fever. Urgent colonoscopy demonstrated multiple punched-out ulcers of intestines from the terminal ileum through the sigmoid colon. Histological specimens taken from the edge of ulcers revealed non-specific inflammation. He showed oral ulcer and multiple gastric ulcers as well as intestinal involvements. Neither physiological and immunochemical findings for Behçet's criteria, nor pathological bacteria and virus were confirmed. We diagnosed non-specific ulceration. He was treated with total parenteral nutrition and intravenous injection therapy of 50 mg of predonisolon (PSL) per day. This therapy resulted in adequate disease control and was followed by the recurrence afterwards during a dose reduction of PSL. Systemic and gastrointestinal manifestations improved markedly after combination therapy of PSL and azathioprine. This case suggested that combination therapy of PSL and immunosuppressive agent appear to be potentially effective in severely developed non-specific intestinal ulceration.