Diagnosis and Management of Nonspecific Colon Ulcer

A child with simple ulcer of the colon effectively treated with the combination of prednisolone, azathioprine, and pentoxifylline

“…[1][2][3][4][5] However, the etiology has yet to be elucidated, and so far few pediatric patients have been reported. 3,5 Ona et al 3 reviewed 127 current cases of nonspecific colonic ulcer and reported the location to be most frequently at or around the cecum (67%). Moreover, the histological findings of simple ulcer tend to show nonspecific inflammation, and thus it is difficult to differentiate simple ulcer of the colon from intestinal Behcet's ulcer.…”

“…[1][2][3][4][5] The complications of perforation have been sporadically reported 5 and the recurrence rate of these ulcers after surgery, including intestinal Behcet's disease, is 70%, 6 which often results in a therapeutic dilemma. If simple ulcer of the colon occurs at a young age, such patients may suffer secondary complications due to inadequate nutrition and immunosuppressive drugs.…”

“…[1][2][3][4][5] However, differentiating this disease from Behcet's ulcer is often impossible pathologically, and the clinical course of simple ulcer may also prove difficult to manage because of resistance to conservative internal treatments and a high recurrence rate after surgical resection. [1][2][3]6 This article describes a 7-year-old girl with simple ulcer of the colon, who was effectively treated with prednisolone, azathioprine, and pentoxifylday by month) and salazosulfapyridine (1.5 g/day). After the treatment, her abdominal pain and fever disappeared and the C-reactive protein concentration immediately decreased, to less than 0.5 mg/dl in 2 weeks.…”

Diseases of the cecum: a CT pictorial review

“…The CT findings closely mimic cecal carcinoma with mass-like thickening to the wall of the cecum or ascending colon, with stranding in the pericolonic fat (Fig. 21), and is associated with perforation in up to 19% of cases [33,34]; therefore, it is often not diagnosed preoperatively and patients often undergo surgery for suspected carcinoma, appendicitis, or diverticulitis. Some patients have been treated conservatively when colonoscopy and biopsy of the ulcer have ruled out carcinoma and the ulcers heal spontaneously [31].…”

Idiopathic cecal ulcer: CT findings

“…Definitive diagnosis is usually obtained by histologic evaluation of the surgical specimen. Preoperative clinical diagnosis is uncommon, requiring the exclusion of all known causes of cecal or ascending colon ulceration and mass, such as inflammatory bowel disease, neoplasm, appendicitis, tuberculosis, or amebiasis [2][3][4]. Although difficult to obtain, an accurate preoperative diagnosis would be beneficial in those patients without morbid features such as hemorrhage or perforation, because conservative management is possible [5].…”