Mechanical ileus as a result of scar tissue stenosis of the small intestine

Česká verze

Authors: L. Puszkailer; J. Smetka
Authors place of work: Chirurgicko-traumatologické oddělení nemocnice Šternberk SMN, a. s., primář: MUDr. J. Smetka
Published in the journal: Rozhl. Chir., 2016, roč. 95, č. 11, s. 413-415.
Category: Kazuistika

Summary

Introduction:
Ileus accounts for about 20% of all acute abdomen onsets. Etiologically and clinically, it is a very heterogeneous group of diseases. The presented case report shows other possible causes of ileus.

Case report:
The authors present a case of mechanical ileus in a 40 years old female admitted and operated due to mechanical ileus. Preoperative imaging methods and the postoperative finding showed stenosis of the small intestine. This finding was resolved by resection of the stenotic part of the intestine. Chronic inflammation, heterotopic gastric mucosa and mucosal ulceration were described based on histology.

Discussion:
In the presented case, the authors discuss the etiology of intestinal stenosis. The authors consider as a possible cause blunt abdominal trauma or an ulcerogenic lesion in the terrain of heterotopic gastric mucosa.

Conclusion:
The diagnosis and treatment of ileus conditions are well known to all surgeons. The presented case report discusses other possible causes of mechanical ileus.

Keywords:
mechanical ileus − posttraumatic stenosis − heterotopic gastric mucosa

Zdroje

1. Kusmenkov T, Kasparek MS, Brumann M, et al. Posttraumatic adhesive ileus following pelvic ring fracture. Unfallchirurg 2015;118:808–11.

2. Hurt AV, Ochsner JL, Schiller WR. Prolonged ileus after severe pelvic fracture. Am J Surg 1983,146:755–7.

3. Hirota C, Iida M, Aoyagi K, et al. Posttraumatic intestinal stenosis: clinical and radiographic features in four patients. Radiology 1995;194:813−5.

4. Kang GH, Jeon TJ, Seo DD, et al. Ileal stenosis occurred 3 months after blunt abdominal trauma. Korean J Gastroenterol 2011;57:370−3.

5. Happe MR, Woodworth PA. Meckel‘s diverticulum in an adult gastrointestinal bleed. Amer J Surg 2003;186:132−3.

6. Stacke J, Kerekes Z. Heterotopická žaludeční sliznice v proximálním jícnu. Čes a slov gastroenterologie a hematologie 2004;58:163−8.

7. Acea Nebril B, Bouso Montero M, Blanco Freire N, et al. Heterotopic gastric mucosa in the ileum with perforated ulcer. Gastroenterol Hepatol 1996;19:514−6.

8. Atik FA, Ricci M, Del Grande JC, et al. Obstruction of terminal ileum due to heterotopic gastric mucosa. Rev Assoc Med Bras 1998;44:340−3.

9. Koshikawa Y, Nakase H, Matsuura M, et al. Ischemic enteritis with intestinal stenosis. Intest Res 2016;14:89−95.

10. Takeuchi N, Naba K. Small intestinal obstruction resulting from ischemic enteritis: a case report. Clin J Gastroenterol 2013;6:281−6.

11. Schölmerich J. Complications of chronic inflammatory bowel disorders: treatment. Praxis, Bern 1994 2005;94:1671−9.