An Adult Case of Multiple Ileal Mucosal Diaphragms

Yuichi Tanaka, Takao Hanaoka, Tamotsu Kudo, Rikko Lee, Shinichiro Ouchi, Akira Tsuchiya, Tomoyuki Kusano, Taiji Seto, Chiaki Hatazawa*

Departments of Surgery and Pediatric Surgery^*, Nakadori Hospital

An extremely rare case of multiple ileal mucosal diaphragms in a 63-year-old man is reported. Previously he had undergone surgery for rectal cancer in our hospital in March 1989. Prior to that, there was no past history of intestinal obstruction. He was readmitted due to postoperative ileus in September 1989, and underwent relaparotomy. During adhesiolysis, multiple mucosal diaphragms were incidentally found in the proximal ileum. Each diaphragm had one orifice whose diameter ranged from pin-hole like to 10 mm. The majority of the diaphragms were removed by resection of 50 cm of the ileum with end-to-end anastomosis. Using tubes of jejunostomy and cecostomy, smooth passage through the lumen of the residual small intestine was confirmed before anastomosis. Histologically the mucosal diaphragm contained hypertrophied muscularis mucosae. Congenital jejuno-ileal stenosis in an adult is extremely rare, and as far as we investigated, only six cases have been reported in the world.

Key words
congenital ileal stenosis, multiple mucosal diaphragms, adult case

Reprint requests
Yuichi Tanaka Department of Surgery, Nakadori Hospital
3-15 Misono-cho, Minami-dori, Akita, 010 JAPAN

Accepted
January 12, 1994

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