Bleeding Ulcer in the Ileum after Removal of a Long Intestinal Tube

• Published in: Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine) Vol. 20; no. 5; pp. 733 - 736
• Main Authors: Kihara, Hajime, Naritaka, Yoshihiko, Ogawa, Kenji, Shimakawa, Takeshi, Wagatsuma, Yoshihisa, Nagata, Kouichi, Utada, Takahito, Katsube, Takao, Haga, Shunsuke, Kajiwara, Tetsuro
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society for Abdominal Emergency Medicine 2000
• ISSN: 1340-2242; 1882-4781
• DOI: 10.11231/jaem1993.20.733

The patient was a 70-year-old man in whom a long tube had been used for intestinal splinting after the surgical division of ileus-causing adhesions. Several hours after the removal of the tube on postoperative day 12, the patient passed bloody stools. A diagnosis of small intestinal bleeding was made by abdominal angiography, and the patient underwent an emergency operation. A segment of the ileum containing a bleeding ulcer was removed. A histological examination suggested that the mucosal and submucosal microcirculation had been impaired by mechanical compression as a result of the long tube, and that this had caused an ulcer to form in a fibrotic region where the bowel had been injured during the initial division of the adhesions.