Korean J Gastrointest Endosc.  2010 Jul;41(1):56-60.

A Case of Simple Ulcer of the Terminal Ileum Successfully Treated by Monoclonal Antibody to Tumor Necrosis Factor-alpha (Infliximab)

• Lee SJ
• Chung WC
• Lee KM
• Oh YS
• Kim EJ
• Choi KH
• Paik CN

Abstract

Nonspecific and idiopathic ulcer of the small bowel or colon is a rare condition, and it is the so called "simple ulcer" when the patients do not have systemic symptoms of Behcet's syndrome. Differentiation of simple ulcer from intestinal Behcet's disease according to the endoscopic and pathologic findings is often impossible and the clinical course of the 2 maladies is similar. A 51-year-old man presented with low abdominal pain, and colonoscopy revealed a huge deep ulceration with an entero-enteric fistula in the terminal ileum. He was diagnosed with simple ulcer without the constitutional symptoms of Behcet's syndrome. He was refractory to conventional therapy with corticosteroids and antibiotics, and so he required surgical resection. Monoclonal antibody against tumor necrosis factor-alpha (Infliximab) was administered at 0, 2 and 6 weeks. His symptoms were relieved after the therapy and the ulceration had completely resolved after 1 year. He was entirely asymptomatic at the 36 month follow up.

Keyword

Behcet syndrome; Tumor necrosis factor-alpha; Infliximab

MeSH Terms

Abdominal Pain
Adrenal Cortex Hormones
Anti-Bacterial Agents
Antibodies, Monoclonal
Behcet Syndrome
Colon
Colonoscopy
Fistula
Follow-Up Studies
Humans
Ileum
Middle Aged
Tumor Necrosis Factor-alpha
Infliximab
Ulcer
Adrenal Cortex Hormones
Anti-Bacterial Agents
Antibodies, Monoclonal
Tumor Necrosis Factor-alpha