A Case of Stenosis of the Small Bowel Following Abdominal Blunt Trauma

Yukio Kamohara, Hitoshi Yamaie, Yuji Shigeoka, Hajime Yoshinaga, Fumikazu Aoki, Yoshifumi Kajiwara¹⁾, Takashi Kanematsu¹⁾

Department of Surgery, Obase Hospital
Second Department of Surgery, Nagasaki University¹⁾

Stenosis of the small bowel following abdominal blunt trauma is rare. We report a case caused by falling and discuss the previous reports. The patient, a 56-year-old man, fell from his motorcycle and sustained a blunt injury to the lower abdomen. Ultrasonography and computed tomography revealed intraabdominal bleeding when he was admitted to our hospital. Conservative therapy was administered, and the clinical findings improved. On the 14th day after admission, abdominal pain and vomiting occurred. A long tube was inserted, and the symptom improved. Enterography revealed stricture of the ileum. Surgery was performed because the ileus-like symptoms recurred. On laparotomy, it was found that the ileum was stenotic about 50 cm from Bauhin's valve, and the mesentery was cicatrized. Resection was performed and the clinical course was good. Pathological examination revealed annular ulcer (UI-II), granulation with fibrosis, and inflammatory cell infiltration. It was considered that localized circulatory distrubance of the ileum due to abdominal blunt trauma caused the cicatrized stenosis.

Key words
abdominal blunt trauma, stenosis of the small bowel

Reprint requests
Yukio Kamohara Department of Surgery of Obase Hospital
1598 Aratsu, Kanda-cho, Miyako-gun, Fukuoka, 800-03 JAPAN

Accepted
December 8, 1993

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