Delayed posttraumatic ischemic stricture of the small intestine. A clinicopathologic study of four cases

Three men and one woman with delayed posttraumatic ischemic stricture of the small intestine were studied, clinicopathologically. Three sustained trauma in traffic accidents, and the other one was injured at a workshop. The chief signs and symptoms were repeatedly occurring incomplete intestinal obstruction. The interval between operation and trauma ranged from 1.5 to 14 months, with a mean of 4 months. The lesions were present in the jejunum 150 cm distant from the ligament of Treitz in one, and in the terminal ileum in three. Shallow ulcers, transmural inflammation, fibromusculosis, and neovascularity in the submucosa, as well as siderophages and foreign body reaction in the subserosa were evident, microscopically. The associated deeper ulcers proximal to the strictures in three were considered to have been induced by ischemic plus mechanical factors.