Clinical characteristics and surgical management of ileal strictures caused by ischemic enteritis: a report of three cases.

Abstract

Ischemic enteritis (IE) is characterized by blood flow insufficient to meet metabolic demands. The incidence of IE is increasing owing to the aging population and advancements in radiographic and endoscopic diagnostics. Many patients eventually require surgical management, indicating an irreversible and progressive pathology. Therefore, clear definitions, early diagnosis, and tailored treatments are crucial. Herein, we report three patients with ileal strictures caused by IE who were successfully treated with surgical resection. In all three cases, the stricture was segmental and located within 50 cm from the ileocecal valve, which is a characteristic radiological feature of IE. Histological analysis revealed segmental, circumferential ulcers with inflammatory-cell infiltration, and fibrosis, although the presentation may vary with the disease phase. Clinicians and surgeons should consider IE in patients with small bowel obstruction and segmental strictures without apparent acute ischemia, especially in older patients with severe comorbidities such as hypertension, diabetes, hyperlipidemia, or thromboembolic diseases.