A Case of Ileus Due to a Simple Ulcer of the Small Intestine Treated with Laparoscopy-Assisted Surgery

Abstract

An 83-year-old man was seen at our hospital because of abdominal pain. Stenosis of the ileum was detected by enteroscopy, but there was no evidence of malignancy in the biopsy results. Therefore, he underwent endoscopic dilatation.
Three months later, he was readmitted with recurrence of abdominal pain. Because there was stenosis at the same site and he had symptoms of ileus, we inserted an ileus tube, decompressed the intestinal tract, and performed laparoscopy-assisted surgery. The pathological diagnosis was simple ulcer.
A simple ulcer of the small intestine is classified as a non-specific ulcer, and it is a rare disease that shows histopathologically non-specific inflammation and a macroscopically deep ulcer. As a simple ulcer of the small intestine is often resistant to conservative treatment, most patients require surgical treatment; until recently, open surgery was the standard procedure.
When the case requires emergency surgery due to bleeding or perforation, indication of laparoscopic surgery is sometimes difficult. However, ileus due to a simple ulcer of the small intestine, where decompression is possible, is a good indication of laparoscopic surgery.