内視鏡的に診断した鈍的腹部外傷による遅発性小腸狭窄の1例

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  • A Case of Delyed Post-Traumatic Stricture of the Small Bowel Diagnosed by Preoperative Endoscopy.

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A 57-year-old man was admitted to our hospital 25 days after a traffic accident in which he was the driver of a car and experienced blunt trauma produced by his seat belt. His chief complaint was vomiting and abdominal pain. Conservative therapy resulted in remission of the symptoms, and he was discharged. On the 48th day after the injury the vomiting and abdominal pain recurred, and he was admitted. Enterography and endoscopy showed pinhole-like stenosis in the ileum about 20cm proximal to Bauchin's valve, and the stenotic region was diagnosed as delayed post-traumatic stricture. The affected small bowel was resected, and examination of the resected specimen revealed an annular ulcer. Histopathological study revealed ulceration and fibrosis in the stenosed segment of the small intestine. This is the first case in which endoscopic findings contributed to making a definite diagnosis of delayed post-traumatic stricture of the small bowel.

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