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KMID : 0988920160140010089
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Intestinal Research
2016 Volume.14 No. 1 p.89 ~ p.95
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Ischemic enteritis with intestinal stenosis
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Yorimitsu Koshikawa
Hiroshi Nakase
Minoru Matsuura
Takuya Yoshino
Yusuke Honzawa
Naoki Minami
Satoshi Yamada
Yumiko Yasuhara
Shigehiko Fujii
Toshihiro Kusaka
Dai Manaka
Hiroyuki Kokuryu
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Abstract
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A 75-year-old man was admitted to our hospital with sudden onset of vomiting and abdominal distension. The patient was taking medication for arrhythmia. Computed tomography showed stenosis of the ileum and a small bowel dilatation on the oral side from the region of stenosis. A transnasal ileus tube was placed. Enteroclysis using contrast medium revealed an approximately 6-cm afferent tubular stenosis 10 cm from the terminal ileum and thumbprinting in the proximal bowel. Transanal double-balloon enteroscopy showed a circumferential shallow ulcer with a smooth margin and edema of the surrounding mucosa. The stenosis was so extensive that we could not perform endoscopic balloon dilation therapy. During hospitalization, the patient's nutritional status deteriorated. In response, we surgically resected the region of stenosis. Histologic examination revealed disappearance of the mucosal layer and transmural ulceration with marked fibrosis, especially in the submucosal layer. Hemosiderin staining revealed sideroferous cells in the submucosal layers. Based on the pathologic findings, the patient was diagnosed with ischemic enteritis. The patient's postoperative course was uneventful.
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KEYWORD
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Ischemia, Intestines, Stenosis, Double-balloon enteroscopy
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