Abstract
The case involved a 50-year-old man who had been admitted to a hospital for close observation of clinical course after his abdomen was caught in a machine at the age of 20. This time he presented to our hospital because of abdominal pain and vomiting. There was slight tenderness in the entire abdomen, but rebound tenderness was absent. An abdominal contrast-enhanced CT scan showed stenosis of the ileum and dilatation of the intestine proximal to the stenosis. Laparotomy performed with a diagnosis of small bowel stenosis on the 5th hospital day revealed that the abdominal wall, greater omentum and small bowel mesentery adhered each other in a straight line at the same area where was involved in the blunt trauma, at where small bowel stenosis was confirmed. We performed adhesiostomy + partial resection of small intestine + appendectomy. It took times to restore the peristalsis but he was discharged from our hospital on 31st postoperative day.
It can occur that patients who sustained abdominal blunt trauma present with symptoms of small bowel stenosis after a lapse of certain times, and it is known as delayed small bowel stenosis. The disease has been reported to occur within 30 days after the trauma in many cases, but it rarely occurs after a long interval following the trauma, like in this case. It is important to keep in mind that recurrent intestinal stenosis can be caused by delayed small bowel stenosis and to confirm whether the patient has a history of sustaining abdominal trauma by patient interviews.
