Small bowel obstruction secondary to a giant enterolith complicating Crohn’s disease

Abstract

Plain film radiography and computed tomography play a central role in establishing the diagnosis of this rare complication of Crohn's disease and assist in planning surgical intervention.

Single large enterolith in a cat with chronic inflammatory enteropathy

“…Primary enteroliths form in areas of bowel stasis; causes of which that have been reported in human medical literature include intestinal diverticula (e.g., Meckel's diverticulum), surgical side-to-side enteroanastomoses, blind pouches, incarcerated hernias, intestinal kinking due to intra-abdominal adhesions, small intestinal tumours, and stenosing or stricturing Crohn's disease. 1,11,[17][18][19][20][21][22][23] Primary true enterolithiasis in human patients with unremarkable medical history is extremely rare. 24 Single enteroliths less than 2 cm have been reported to pass without complication in people, but if retained may become a nidus for additional deposition of mineral.…”

“…1 Patients often develop clinical signs of acute or subacute small bowel mechanical obstruction, including nausea, vomiting, abdominal pain and/or distension and constipation. 1,11,[17][18][19][20][21][22][23] The symptoms can be fluctuating in nature, as the enterolith passes through the gastrointestinal tract. 1,20 Our case had longstanding clinical signs of chronic vomiting and weight loss, with no specific inciting cause and without an acute component to suggest gastrointestinal obstruction.…”

“…25 Surgical removal of the enteroliths and addressing any underlying pathology to prevent future occurrence are the cornerstones of treatment. 2,8,11,12,14,[17][18][19][20][21][22][23] There have been rare reports of successful medical management in human patients. 26 Our patient improved significantly after the enterolith and affected intestinal segment was removed, despite the absence of therapy for chronic enteropathy.…”

Subacute intestinal obstruction by enterolith: a case study

“…In Crohns disease, multiple areas of small bowel stenosis are relatively common, but there are only few reported cases with stenosis complicated by enterolith. Geoghegan et al (2005) reported a case of small bowel obstruction secondary to a giant enterolith in a patient of Crohn’s disease. Svanes and Halvorsen (1975) and Klinger et al (1999) reported cases of enteroliths in jejunal diverticulae.…”

Intermittent small bowel obstruction secondary to enterolithiasis in Crohn's disease

“…But we can not discard them with a normal X-ray because some of them are radiolucent (made of magnesium salts). In these cases the study should be completed with CT scan (4,5).…”