Abstract
Ischemic enteritis uncommonly occurs in the small intestine and such enteritis causing intestinal obstruction is rarely encountered. This paper describes a case of ischemic jejunitis causing intestinal obstruction with a review of the Japanese literature.
A 77-year-old female was admitted to the hospital because of abdominal distension and vomiting. There was a history of hypertension. Physical findings on admission revealed paralytic ileus. Conservative treatment improved abdominal distension and allow the patient oral intake. But 4 weeks later, the patient developed abdominal distension again, and mechanical obstruction of the jejunum was indicated by abdominal X-ray examination. Coservative treatment for 3 days failed to improve the condition. Laparotomy was performed and segmental stenosis of the jejunum about 15cm in length at about 60cm distant to the Treitz's ligament was found. The jejunum oral to the stenosis was remarkably distended. Pulsation was not palpable at the marginal artery of the stenotic segment, but the supuior mesenteric artery was found to be normal. Resection of the stenotic jejunum and end-to-side anastomosis were performed. Histopathologically the patient was disgnosed as ischemic enteritis with necrosis of mucosa and marked siderofer cell infiltration.
