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

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

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.

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Fig. 1.
Coronal abdominal computed tomography. It demonstrated segmental luminal narrowing and stricture in mid ileum (arrow heads).
kjg-57-370f1.tif
Fig. 2.
Small bowel series. It showed segmental luminal narrowing and stricture with ulceronodular mucosa (arrow heads).
kjg-57-370f2.tif
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.
kjg-57-370f3.tif
Fig. 4.
Histopathological finding. Ulcers were observed and inflammatory cells and fibroblasts infiltrated to the whole layers (H&E,×40).
kjg-57-370f4.tif
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