A Case of Post-Traumatic Small Intestinal Stenosis Treated by Laparoscopy-Assisted Surgery

• Published in: Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine) Vol. 38; no. 7; pp. 1141 - 1144
• Main Authors: Azami, Ayaka, Takano, Yoshinao
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society for Abdominal Emergency Medicine 30.11.2018
• ISSN: 1340-2242; 1882-4781
• DOI: 10.11231/jaem.38.1141

We report herein on a case of delayed small intestinal stenosis following blunt abdominal trauma treated with laparoscopy-assisted surgery. A 64-year-old male was transferred to our hospital due to a traffic accident. He was diagnosed as having a mediastinal hematoma caused by an internal thoracic arterial injury, rib fracture, with pulmonary and abdominal contusion. An emergency arterial embolization and mediastinal drainage operation were performed. Three weeks later, he experienced abdominal pain. CT revealed local stenosis of the small intestine. He was diagnosed as having ileus. A long tube was inserted and the patient underwent laparoscopic assisted adhesiolysis and small intestinal resection on the 29th day. Intraluminal stenosis of the ileum at 20cm proximal from the ileocecum was detected, and this portion was resected. The stenosis was caused by a direct small intestinal injury not by circulatory impairment. Almost all cases of stenosis of the small intestine are irreversible. We found laparoscopy to be useful in diagnosis and treatment when post-traumatic intestinal stenosis could not be definitively identified.