Abstract
A case of injury of the superior mesenteric vein caused by blunt trauma on the abdomen was experienced. A 29-year-old man got a bruise on the upper abdomen by a timber while at a work. On admission blood pressure was 110/68 mmHg, and pulse rate was 78/min. An abrasion on the upper abdomen and slight peritoneal signs were observed. Laparotomy was carried out and an about 700 ml of blood collection was found in the abdomen. There was a perforation in the jejunum 30 cm distant from Treitz'ligament, and in a part of small intestine starting from 70 cm anal-side from the perforation to the end of ileum, discoloration to dark red was observed. The superior mesenteric vein completely teared at a site immediately after running up the bifurcation of the 1st jejunal vein, and the both ends were occluded with thrombus. As the general condition was stable, revascularization was performed by using a great saphenous vein but the revascularized vein was closed soon. Transiently, GOT, LDH, and CPK levels markedly increased, however, no infarct necrosis of the small intestine occurred. The patient has been suffering from chronic diarrhea and malnutrition as complications, as of 9 months after surgery.
