A Case of Ruptured Submucosal Aneurysm of the Jejunum

Kimimasa Narita, Nobuhito Sugihira, Takeshi Yamamura, Tohru Masuda, Hide Yano and Kiwamu Sakakura

Department of Surgery, Mie Prefectural General Medical Center

An 18-year-old woman was admitted to the hospital with a massive intestinal hemorrhage resulting in shock. The bleeding point was not detected by the fiberscopic examination of the stomach, duodenum and colon. Repeated abdominal angiography did not reveal the intestinal bleeding point, so an exploratory laparotomy was performed. A hard mass 1 cm in a diameter was found at 90cm on the anal side of the jejunum from the Treitz ligament. Partial resection of the jejunum including the hard mass was performed, and her postoperative course was uneventful. She was discharged two weeks after the operation. In the case of massive intestinal hemorrhage, emergent exploratory laparotomy is recommended when angiographic and scintigraphic examinations cannot visualize the bleeding point.

Key words
submucosal aneurysm, massive bleeding, abdominal angiography

Reprint requests
Kimimasa Narita Department of Surgery II, Mie University Medical School 2-174 Edobashi, Tsu, 514-8507 JAPAN

Accepted
November 27, 2001

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