Three cases with Crohn's disease initially found with aphthoid ulcers by double contrast barium enema were reported with special attention to the change of the radiological findings in their clinical courses for more than 10 years. (Case 1) A 16-year-old man was referred to our clinic with complaints of fever and diarrhea. The initial double contrast barium enema revealed aphthoid ulcers scattered throughout the colon. Those aphthoid ulcers disappeared one year and five months later, but they came out again two years after the first barium enema. Three years and five months after the initial examination, he developed longitudinal ulcers and cobblestone-like lesions that were commonly seen in advanced Crohn's disease. The follow up barium enema examinations after five and 15 years showed small aphthoid ulcers on the atrophic mucosa in the shortened and strictured colon. (Case 2) A 52-year-old woman was presented to our clinic with high fever and diarrhea. The initial examination of double contrast barium enema showed small aphthoid ulcers scattered on the entire colon. Those aphthoid ulcers disappeared three months later, but they were found again by barium enema one year later. They were exacerbated and developed longitudinal ulcers and cobblestone appearance two years and one month after the initial examination. She had received a continuous and strict elemental diet therapy, barium enema examinations 10 years and eight months and 15 years after the initial examination showed a longitudinal ulcer scar with stricture only, but no aphthoid ulcers. (Case 3) A 51-year-old woman visited to our clinic with high fever and diarrhea. The initial double contrast barium enema demonstrated numerous aphthoid ulcers scattered throughout the colon. Those aphthoid ulcers had remittence and relapse for 10 years, and were still demonstrated by barium enema 10 years after the first visit. Aphthoid ulcers originally found in the middle of small intestine, disappeared once, but flared up and developed into short longitudinal ulcers, then typical longitudinal ulcers with cobblestone appearance in 10 years. Aphthoid ulcers in the first colon examination once disappeared, but recurred and developed into the typical radiological findings of Crohn's disease. They were still found on the atrophic mucosa of the colon after 10 years. These cases suggested that aphthoid ulcers would be an important finding of Crohn's disease as an initial as well as an essential sign.
|Number of pages||10|
|Journal||Stomach and Intestine|
|Publication status||Published - 09-1999|
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