Crohn's disease and carcinoma of colon.

作者：A. D. Perrett, S. C. Truelove, G. R. Massarella · 发表于：BMJ · 年份：1968 · DOI：10.1136/bmj.2.5603.466 · 被引用次数：73 · 研究领域：Gastrointestinal Tumor Research and Treatment、Inflammatory Bowel Disease、Metastasis and carcinoma case studies

In a recent survey of Crohn's disease undertaken at the Radcliffe Infirmary three cases were encountered in which both carcinoma of the colon and Crohn's disease were present.As it is generally held that there is no association between these two diseases it seems important to report these cases and to discuss the possibility that a genuine association exists.Case 1 A housewife was first admitted to the Radcliffe Infirmary in October 1949 at the age of 34.She gave a history of eight months' diarrhoea and loss of weight, and two weeks' history of lower abdominal pain.She was emaciated and a mass was palpable in the right iliac fossa.Investigations.-Haemoglobin 7.2 g./100 ml.Blood film- marked iron-deficiency changes.Stools-repeatedly positive for occult blood, negative for pathogens, no acid-fast bacilli on culture.Barium enema showed an irregular filling defect of the caecum, together with narrowing of a short segment of the pelvic colon.At operation in November 1949 the appearances were those of a malignant lesion of the caecum, to which the sigmoid colon and coils of terminal ileum were adherent.A right hemicolectomy, ileal resection, and sigmoid resection was carried out, with end-to- end anastomosis of the left colon, and end-to-side ileotransverse colostomy.The caecum contained a large soft carcinoma which had partially infiltrated the caecal wall.There were adhesions between caecum and overlying loops of ileum.Histologically the tumour was a moderately differentiated pap...