A case of ischemic stricture of the jejunam due to ischemic enteritis

Abstract

Ischemic enteritis of the small intestine is rather rare and often affectes aged patients with underlying diseases including hypertension, cerebrovascular disease, ischemic heart disease, and diabetes mellitus.
A 32–year–old man visited a hospital because of abdominal distention. He had had occasional bouts of the symptom for 10 years. He had received conservative treatment for a suspected bowel obstruction in another hospital one year before visiting our hospital. Plain abdominal X–ray showed niveau sign in the small intestine. Abdominal CT scan showed a mass like lesion in the left lower abdominal quadrant which was continuous to the dilated small intestine. A contrast medium test of the small intestine showed a stenotic portion 4 cm in length which completely encircled the lumen and was located at about 200 cm anal side from the Treitz′s ligament. We diagnosed it as a tumor of the small intestine, and carried out partial resection of the small intestine which included four stenotic sites. Histopathological study revealed thinness of the mucosa and fibromuscular expansion of the submucosa which was associated with ischemic enteritis.