Bleeding Ulcer in the Ileum after Removal of a Long Intestinal Tube

Abstract

The patient was a 70-year-old man in whom a long tube had been used for intestinal splinting after the surgical division of ileus-causing adhesions. Several hours after the removal of the tube on postoperative day 12, the patient passed bloody stools. A diagnosis of small intestinal bleeding was made by abdominal angiography, and the patient underwent an emergency operation. A segment of the ileum containing a bleeding ulcer was removed. A histological examination suggested that the mucosal and submucosal microcirculation had been impaired by mechanical compression as a result of the long tube, and that this had caused an ulcer to form in a fibrotic region where the bowel had been injured during the initial division of the adhesions.