A CASE OF ISCHEMIC STRICTURE OF THE SMALL INTESTINE AFTER ABDOMINAL ANGIOGRAPHY

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  • 腹部血管造影検査後に発症した虚血性小腸狭窄の1例

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Abstract

Ischemic stricture ofthe small intestine is a rare entity. We experienced a case of ischemic stricture ofthe small insestine after abdominal angiography.<br> A 72-year-old man was admitted tothe hospital forthe purpose of transarterial embolization (TAE) for hepatic cancer which was detected during observation of clinical course of liver cirrhosis. On abdominal angiography, selective insertion of a chateter was impossible and we could not perform TAE. Afterthe angiography, he developed an abdominal pain. Abdominal CT scan on the next day revealed splenic infarction and bilateral renal infarction.The abdominal pain sustained, and gaseous distention and air-fluid level formation were intensified with time. Fluoroscopic study of the small intestine on 69th day after the angiography revealed a stricture about 7cm in length at the middle of the small intestine. Based on his clinical course, ischemic stricture of the small intestine due to embolus was diagnosed, and the patient was operated on. At operation, the stricture was present about 2cm oral from the terminal ileum, and an excision of the small intestine includingthe stricture was performed.The resected material disclosedthickenning of the wall at the stricture. Histopathological study revelaed ulcer extending to submucosa and ulcer scars. We must entertain a possibility of ischemic enteritis in the treatment of acute abdomen following angiography.

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