Serum sialic acid was measured to evaluate the activity of Crohn's disease. The sialic acid levels of patients with Crohn's disease in remission (CRP 0.0 mg/dl) were significantly higher than those of healthy subjects and postoperative patients with Crohn's disease. In patients in remission, serum sialic acid was significantly correlated with hemoglobin, hematocrit, platelet, and rapid turnover protein. Correlations with platelet, retinol-binding protein, and prealbumin were especially strong. From these findings, it was concluded that serum sialic acid level provides a useful index of the activity of Crohn's disease.
A man was admitted to our hospital because of intestinal reddish bleeding. Colonic varices were found at the cecum by colonoscopy. Angiography of the superior mesenteric artery showed that blood vessels were scant from the end of the ileum to the ascending colon. An operative view revealed the varices, but there was no trace of the ileocecal vein. This case, presenting a deficit of the ileocecal vein, indicated that the blood flow could not return via the ileocecal vein, and therefore there was an outflow through the varices to the surrounding intestine or abdominal veins. Such a case is probably unrepresented in the literature because it was caused by the total deficiency of the ileocecal vein and it was in the right colon.
Esophageal lesions are rarely seen in patients with intestinal Behçet's disease. Three patients with esophageal lesions (dissection of esophageal mucosa, esophageal ulcer, esophageal varices) were observed among 15 patients with intestinal Behçet's disease or non-specific simple ulcer (1974-1984). Two-thirds of these fifteen patients had fully developed or suspected Behçet's disease, and one-third had no symptoms typical of Behçet's disease. They are classified as non-specific simple ulcer. The average age of the 15 patients was 43 years, all patients but one were male. The recurrence rate after surgical treatment was 70%, that of medical treatment was 90%.
A case of esophageal Crohn's disease is described. Crohn's lesion was observed in the lower esophagus, and sarcoid-like granulomas were found in the biopsied specimen. A clinical consideration of this phenomenon is presented.
Colonoscopic characteristics of aphthoid ulcers in amebiasis, Crohn's disease, and tuberculosis were evaluated. Multiple aphthoid ulcers were featured in 14 out of 15 cases of amebiasis, 7 out of 74 cases of Crohn's disease, and 5 out of 24 cases of tuberculosis. Aphthoid ulcers of amebiasis were often confined to the rectum and lower sigmoid colon, being characterized by marginal elevation and erythema. Crohn's aphthoid ulcers lacked the red halo in all but one case. No verrucous elevations were observed. The intervening mucosa appeared intact in all cases. Aphthoid ulcers of intestinal tuberculosis were oval or lozenge‐shaped. They were surrounded by a marginal red halo in 4 cases (80%), however, the red halos found in tuberculosis patients were milder than those of patients with amebiasis. Aphthoid ulcers of Crohn's disease and tuberculosis showed a tendency to be arranged in a specific direction. Crohn's ulcers were arranged in a longitudinal fashion, whereas tuberculous ulcers were arranged in a circular fashion. Ulcers of amebiasis were arranged entirely at random. Biopsy from aphthoid ulcers of amebiasis showed parasites in 64%, whereas cytological studies were positive in 93% of cases.
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