A Case of Ischemic Stenosis of the Small Intestine

Satoru Nishimura, Satoru Matsusue, Shunzo Koizumi, Sadao Kashihara

Department of Abdominal Surgery, Tenri Hospital

A case of ischemic stenosis of the small intestine was successfully managed. A 61-yera-old male developed abdominal pain, vomiting and diarrea after an aortobifemoral bypass for Leriche syndrome. He was diagnosed by computerized tomography as having an intrabdominal abscess, and was transferred to our department for drainage. Although he underwent a drainage procedure, his complaints remained the same. Besides, mechanical obstruction of the small intestine supervened. He was maintained on intravenous hyperalimentation, and examined further. Abdominal angiography revealed stenosis of the superior mesenteric artery, and he was thought to have mechanical obstruction due to an ischemic process. He underwent a laparotomy, which disclosed segmental stenosis of the small intestine associated with an atrophic mesenterium limited to the stenotic segment. Resection of the stenotic small intestine and end-to-end anastomosis relieved his symptoms. Histological examination revealed fibrous granulation throughout the wall of the small intestine and obliterating endarteritis of the mesenteric artery. It is thought that timely diagnosis and therapeutic intervention with adequate nutritional support are essential for optimal care of this disease.

Key words
small intestine, ischemia of the small intestine, stenosis of the small intestine

Reprint requests
Satoru Nishimura Department of Abdominal Surgery, Tenri Hospital
200 Mishima-cho, Tenri, 632 JAPAN

Accepted
November 8, 1989

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