A CASE OF SIMPLE ULCER OF THE TRANSVERSE COLON ARISING IN THE ORAL SIDE OF MEGACOLON

A 46-year-old man was admitted to the hospital because of abdominal distention, upper abdominal pain, and fever. There were previous histories of undergoing operations twice for intestinal obstruction, though details were lacked. Preoperative abdominal x-ray film, CT scan, and barium enema study revealed megacolon covering from the transverse to descending colon, and a tumorous shadow in the colonic mesentery at its oral side. A laparotomy was performed, when remarkable dilatation covering from the transverse to descending colon was seen and deep ulcer lesion was palpated at the hepatic flexure of the transverse colon. A partial resection of the colon including the ulcer was performed. On histopathological study of the resected material, the ulcer revealed findings of non-specific ulcer. It was concluded that the ulcer in this case was simple ulcer originated in the vicinity of megacolon due to some unknown mechanisms. The patient was discharged without any serious problems after the operation, and is followed on an ambulant basis.The etiology of simple ulcer has been still controversial. And there has been no another case of simple ulcer associated with megacolon other than our case as far as we could review. This uncommon case together with some bibliographical comments is presented.