Korean J Gastroenterol.  2011 Jun;57(6):370-373. 10.4166/kjg.2011.57.6.370.

Ileal Stenosis Occurred 3 Months after Blunt Abdominal Trauma

• Kang GH
• Jeon TJ
• Seo DD
• Oh TH
• Kim S
• Cho HS
• Bae BN
• Kim JY

• KMID: 1792802
• DOI: http://doi.org/10.4166/kjg.2011.57.6.370

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.

Keyword

Blunt abdominal trauma; Stenosis

Figure

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  Fig. 1. Coronal abdominal computed tomography. It demonstrated segmental luminal narrowing and stricture in mid ileum (arrow heads).

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  Fig. 2. Small bowel series. It showed segmental luminal narrowing and stricture with ulceronodular mucosa (arrow heads).

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  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.

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  Fig. 4. Histopathological finding. Ulcers were observed and inflammatory cells and fibroblasts infiltrated to the whole layers (H&E,×40).

Reference

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