TWO CASES OF ISCHEMIC ENTERITIS OF THE SMALL INTESTINE

Abstract

Ischemic enteritis of the small intestine is a rare entity and is classified into temporary, stricturing, and gangrenous forms. The temporary and stricturing forms are called ischemic enteritis of the small intestine in a narrow sense, but we think that these forms might be different in the severity resulting from the degree of ischemia. Here we report two cases of ischemic enteritis of the small intestine, one case of stricturing form and the other of gangrenous form.
Patient 1, a 77-year-old man, was admitted to the hospital because of abdominal pain and vomiting. Conservative treatment improved these symptoms and he was discharged from the hospital. However, he was readmitted because of intestinal obstruction. Fifty-five days after the onset of the first symptoms, a laparotomy was performed and a whole circumferential stenosis about 15 cm in length was found at the ileum. Histopathological examination showed U1-II widespread ulcer with marked infiltration of inflammatory cells and fibrosis. The definite diagnosis of ischemic enteritis was made.
Patient 2, a 68-year-old woman, underwent an emergency laparotomy for peritonitis. Pulsation at the main branches of the superior masenteric artery were palpable. Hemorrhagic necrosis of the jejunum about 15 cm in length occurred whole circumferentially and through the entire layers of the intestinal wall. A partial resection of the small intestine was performed.