Two Cases of Delayed Small Bowel Stenosis Following Blunt Abdominal Trauma

Fukumasa Tsuji, Fumitoshi Kimura, Yoshisada Yamasaki, Youichi Yamanaka*

Department of Surgery, Shisou Municipal Hospital
*Yamanaka Clinic

Delayed small bowel stenosis following abdominal blunt trauma is a very rare disease. The author experienced 2 cases of this disease, which are reported below. Case 1: A l5-year-old boy. The chief complaint was vomiting. He had been riding a bicycle and fell, striking the abdominal region. Because the vomiting persisted, the patient visited our hospital and was diagnosed as having small bowel stenosis following abdominal blunt trauma. An operation was performed on the 104th day after the accident. A portion of the jejunum about 5 cm from Treitz's ligament showed stenosis due to a fibrous adhesion, and thus this adhesion was detached. Case 2: A 52-year-old man. The chief complaint was postprandial abdominal pain. The patient was driving a car, which slid into a ditch and he received a blow to the upper abdominal region. Subsequently, he began to have postprandial abdominal pain and a feeling of gastric fullness, which did not improve. On the 41st day after the accident, an operation was performed under the diagnosis of small bowel stenosis following abdominal blunt trauma. The stenosis was found in the jejunum 3 cm anal from Treitz's ligament, and that region was removed and the two ends of the jejunum were anastomosed. The outcome of the surgical treatment in these two cases was good. For diagnosis of this disease, it is very important to suspect this disease and perform small intestinal radiography.

Key words
delayed small bowel stenosis, blunt abdominal trauma

Reprint requests
Fukumasa Tsuji Department of Surgery, Shisou Municipal Hospital
93 Shikazawa, Yamasaki, Shisou, Hyougo, 671-25 JAPAN

Accepted
October 9, 1991

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