Anal Ulcers as a Main Symptom of Ulcerative Colitis

We report a case of anal ulcers as a main symptom of ulcerative colitis. The patient was a 59 year-old man. He was admitted to our hospital on June 8, 1989, complaining of severe anal pain. The anal ulcers were situated at 1 and 7 o'clock. They were broad, deep and hard. They were so characteristic that we suspected the existence of an underlying disease. Syphilis, tuberculosis, leukemia and cancer were excluded from the labolatory data and the biopsy taken at anal ulcers. Finally he was diagnosed as having ulcerative colitis from the colonscopy and barium enema findings. He was treated with IVH, injection of predonisolon and oral medication of salazopyrin. One and a half months later he obtained remission of the colon. At the same time his anal ulcers healed. Ulcerative colitis should be added to the differential diagnosis of the anal ulcer even if abdominal symptoms are mild.