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Multimodality Diagnosis of Mesenteric Ischemia
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Small intestinal obstruction resulting from ischemic enteritis: a case report.

Nobuhiro Takeuchi1, Kazuyoshi Naba

  • 1Division of Gastroenterology, Department of Internal Medicine, Kawasaki Hospital, 3-3-1 Higashiyama-cho, Kobe, Hyogo 652-0042 Japan.

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|August 31, 2013
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Summary

A 69-year-old male experienced small intestinal obstruction due to stenotic ischaemic enteritis. Surgical resection of the affected ileum was ultimately required for successful treatment.

Keywords:
Ischaemic enteritisSingle balloon enteroscopySmall intestinal obstruction

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Area of Science:

  • Gastroenterology
  • Surgical Pathology

Background:

  • Small intestinal obstruction is a common surgical emergency.
  • Ischaemic enteritis can lead to strictures causing bowel obstruction.

Purpose of the Study:

  • To report a case of small intestinal obstruction caused by stenotic ischaemic enteritis.
  • To highlight the diagnostic and therapeutic challenges.

Main Methods:

  • Computed tomography (CT) scan for initial diagnosis.
  • Transnasal ileus tube placement and contrast study.
  • Transanal single balloon enteroscopy for direct visualization.
  • Surgical resection and pathological examination.

Main Results:

  • CT revealed dilated small bowel loops and a distal ileal stricture.
  • Enteroscopy identified circumferential ulcers and a stricture in the distal ileum.
  • Balloon dilation was ineffective.
  • Surgical resection revealed multiple circumferential ulcers consistent with ischaemic enteritis.

Conclusions:

  • Stenotic ischaemic enteritis can cause significant small intestinal obstruction.
  • While endoscopic interventions may be attempted, surgical resection is often necessary.
  • Accurate pathological diagnosis is crucial for understanding the etiology.