Ischemic stricture of the jejunum--report of a case

We report herein a case of an 82 year old Japanese woman admitted to hospital after suddenly experiencing upper abdominal pain and vomiting. An upper gastrointestinal series showed a narrow segment with edematous adjacent loops in the proximal jejunum. On the twentieth day following her admission, a barium-meal radiograph revealed that the narrow segment had progressed to a firm tubular stenosis with effacement of the mucosal pattern. The stenotic segment, resected the following day, was 7 cm long with an internal circumference of only 0.5 cm at its narrowest portion. Histologic examination of the resected specimen showed ulceration and marked edema in the intestinal wall, accompanied by organizing and recanalizing thrombi in the subserosal arteries. These features were strongly suggestive of an ischemic process.