Ileal Stenosis Occurred 3 Months after Blunt Abdominal Trauma

Gun-Hi Kang; Tae Joo Jeon; Dong Dae Seo; Tae-Hoon Oh; Soohyun Kim; Hyun Sun Cho; Byung Noe Bae; Jung Yeon Kim

doi:10.4166/kjg.2011.57.6.370

Journal List > Korean J Gastroenterol > v.57(6) > 1006826

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Kang, Jeon, Seo, Oh, Kim, Cho, Bae, and Kim: Ileal Stenosis Occurred 3 Months after Blunt Abdominal Trauma

Case Report

Korean J Gastroenterol 2011;57(6):370-373.

Published online: 4 October 2011

DOI: https://doi.org/10.4166/kjg.2011.57.6.370

Ileal Stenosis Occurred 3 Months after Blunt Abdominal Trauma

Gun-Hi Kang, Tae Joo Jeon, Dong Dae Seo, Tae-Hoon Oh, Soohyun Kim¹, Hyun Sun Cho¹, Byung Noe Bae², Jung Yeon Kim³

Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea

¹Department of Radiology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea

²Department of Surgery, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea

³Department of Pathology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea

Correspondence to: Tae Joo Jeon, Division of Gastroenterology, Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, 761-1, Sanggye 7-dong, Nowon-gu, Seoul 139-707, Korea. Tel: +82-2-950-8889, Fax: +82-2-950-1955, E-mail: drjtj@paik.ac.kr

Received 30 March 20105 June 2010 Accepted 8 June 2010

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We present a case of ileal stenosis with delayed presentation 3 months after car accident. Ileal stenosis after blunt abdominal trauma is a rare clinical entity. We present CT and small bowel series 3 months after trauma. Image showed segmental thickening of intestinal wall and proximal bowel dilation. At surgery, a stenotic bowel loop was adjacent to a fibrotic mesentery. Histological examination showed ulcers, inflammatory cells and fibroblasts infiltrated to the muscularis mucosae, submucosa, and mesentery. The most likely cause, supported by most authors, implicates an injury to the mesentery. Post-traumatic ischemic bowel stenosis may result from even small tears and contusions of mesentery. Posttraumatic intestinal stenosis should be included in the differential diagnosis in a patient with a history of blunt abdominal trauma and signs of intestinal obstruction.

Keywords: Blunt abdominal trauma, Stenosis

References

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Fig. 1.

Coronal abdominal computed tomography. It demonstrated segmental luminal narrowing and stricture in mid ileum (arrow heads).

Fig. 2.

Small bowel series. It showed segmental luminal narrowing and stricture with ulceronodular mucosa (arrow heads).

Fig. 3.

Gross findings of resected specimen. (A) In gross finding, the ileum was stenosed, the surrounding mesentery was fibrosed hardly, adhesion was serious, and the mesenteric root was shortened. (B) The mucosa showed ulcerative change with necrotic exudates.

Fig. 4.

Histopathological finding. Ulcers were observed and inflammatory cells and fibroblasts infiltrated to the whole layers (H&E,×40).

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