A study on endoscopical aspects of acute terminal ileitis

Abstract

Infection of Yersinia enterocolitica and Anisakis leads to acute terminal ileitis, but the exact pathophysiology is still unknown. We endoscopically examined the terminal ileum in 4 cases of acute terminal ileitis, and observed repeatedly the clinical courses of the lesion in three of them. All the cases complained of fever, pain of the right lower abdomen and diarrhea. In one case, stool culture yielded Yersinia enterocolitica. Other three cases were diagnosed as acute terminal ileitis by the radiological findings, the endoscopical aspects and the clinical pictures. The radiological findings were fine irregularity of the ileal wall, unshapely shadow resembled ulcerations, irregular enlargement of mucosal folds and small scattered filling defects, and in one case, enlargement of the Bauhin's valve. In acute stage the endoscopical aspects of the terminal ileum were ulcerations and erosions. Only one case showed cobble stone appearance. In healing stage, ulcers and erosions disappeared, and small scattered nodules were obseryed, and those were thought lymphoid hyperplasia by biopsyspecimen. After 3-6 months, we obseryed normal endoscopical aspects of the terminal ileum in 3 cases. Thus far, the recurrence of the diseases does not occur. We reported chiefly the endoscopical aspects of 4 cases of acute terminal ileitis. © 1982, Japan Gastroenterological Endoscopy Society. All rights reserved.