Abstract
A 62-year-old male was hospitalized with a diagnosis of intestinal obstruction. No abnormalities were observed in endoscopic examinations of the upper and lower gastrointestinal tracts. An ileus tube was inserted to reduce the pressure in the intestinal tract and a contrast study was conducted. An image of stenosis was observed in the ileum, leading to a diagnosis of stenosis of the small intestine, and laparoscopic surgery was performed. In the perioperative findings, cord-like fibrous adhesions had formed between the small intestine and the pelvic and abdominal walls, and parts of the small intestine had adhered to each other in a loop at a section approximately 50 cm from the terminal ileum. After separating the adhesion from the abdominal wall, the skin incision in the umbilical region was extended to 3 cm and the looped adhesion of the small intestine was exposed outside the abdominal cavity, resected and anastomosed. A histopathological examination revealed multinucleate giant cells in penetrating the ulcer tissues but no other distinct pathological findings were observed and the patient was diagnosed as having a simple ulcer of the small intestine. A simple ulcer of the small intestine is a rare disease and diagnosis is often difficult. It was believed that in cases in which an intestinal obstruction or a disease of the small intestine of unknown cause is suspected, laparoscopic surgery is an extremely useful method for both obtaining a diagnosis and providing appropriate treatment.
