• CIPO
• Chronic intestinal pseudo-obstruction
• Enterolithiasis
• Hydroxypropyl cellulose

• Humans
• Female
• Adolescent
• Chronic Disease
• Lithiasis/complications
• Lithiasis/etiology
• Lithiasis/diagnosis
• Lithiasis/therapy
• Intestinal Pseudo-Obstruction/complications
• Intestinal Pseudo-Obstruction/therapy
• Tomography, X-Ray Computed
• Cellulose/analogs & derivatives

• Intraluminal
• Radiology
• Small bowel obstruction

• Humans
• Intestinal Obstruction/diagnostic imaging
• Intestinal Obstruction/etiology
• Tomography, X-Ray Computed/methods
• Intestine, Small/diagnostic imaging

• Case report
• Enterolithiasis
• Gastrointestinal tract
• Intestinal obstruction

• enterolithiasis
• gallstones
• obstructions
• small bowel obstruction

• blind loop syndrome
• enterolithiasis
• explorative laparotomy
• intestinal pseudo-obstruction
• small bowel resection

• Crohn’s disease
• cystoprostatectomy
• enterolith
• ileal cul-de-sac

• computed tomography
• diabetes mellitus
• gastric bezoars
• lactic acidosis
• small bowel obstruction

• bezoar
• bowel resection
• laparotomy
• small bowel obstruction

• ct features
• enterolith
• gallstone
• intestinal obstruction

• Humans
• Gallstones/complications
• Gallstones/diagnostic imaging
• Gallstones/surgery
• Intestinal Obstruction/diagnostic imaging
• Intestinal Obstruction/etiology
• Intestinal Obstruction/surgery
• Ileus
• Intestine, Small/diagnostic imaging
• Tomography, X-Ray Computed

• Enterolithiasis
• enterolith
• intestinal calculus
• intestinal obstruction
• intestinal stasis

• IBD
• enterolithiasis
• lithotripsy

• cola dissolution therapy
• double-balloon endoscopy
• enterolith

• Female
• Humans
• Aged
• Cola
• Solubility
• Intestinal Obstruction/etiology
• Intestinal Obstruction/therapy
• Endoscopy
• Calculi/complications
• Anti-Inflammatory Agents, Non-Steroidal

• bracken
• foreign body
• small bowel obstruction
• small intestine
• snare fragmentation

• Aged
• Female
• Humans
• Bezoars/complications
• Bezoars/diagnosis
• Bezoars/diagnostic imaging
• Bezoars/therapy
• Double-Balloon Enteroscopy/instrumentation
• Double-Balloon Enteroscopy/methods
• Intestinal Obstruction/diagnosis
• Intestinal Obstruction/diagnostic imaging
• Intestinal Obstruction/etiology
• Intestinal Obstruction/therapy
• Jejunum/diagnostic imaging
• Jejunum/surgery
• Tomography, X-Ray Computed

• Case report
• Conservative management
• Enterolithiasis
• Large bowel obstruction
• Surgery

Enterolith formation is a rare condition precipitated by decreased bowel motility. It may cause obstruction or other complications and the diagnosis usually is confirmed after surgery and analysis of the stones or fragments. It is often seen in association with intestinal abnormalities such as diverticula and inflammation or in biliary tract fistulas where stones migrate to the duodenum and small bowel. We report an unusual case of a primary true enterolith formation in a patient without any underlying bowel condition or any previous surgery.

Small bowel diverticulosis is an uncommon condition which is usually asymptomatic and is discovered incidentally. One rare complication is enteroliths forming in the diverticula causing bowel obstruction. Only a few cases of such have been described in literature, and recurrence from this aetiology has not been reported previously. This case report outlines the management of a 68-year-old male who presented with recurrent small bowel obstruction secondary to jejunal diverticular enterolith impaction, seven months following a previous episode.

A 68-year-old male presented with symptoms of small bowel obstruction. Computed tomography (CT) of the abdomen demonstrated small bowel obstruction from an enterolith formed in one of his extensive jejunal diverticula. He required a laparotomy, an enterotomy proximal to the enterolith, removal of the enterolith, closure of the enterotomy, and resection of a segment of perforated ileum with stapled side-to-side anastomosis. Seven months later, he represented to emergency department with similar symptoms. Another CT scan of his abdomen revealed a recurrent small bowel obstruction secondary to enterolith impaction. He underwent another laparotomy in which it was evident that a large enterolith was impacted at the afferent limb of the previous small bowel anastomosis. A part of the anastomosis was excised to allow removal of the enterolith and the defect was closed with cutting linear stapler. In the following two years, the patient did not have a recurrent episode of enterolith-related bowel obstruction.

The pathophysiology underlying enterolith formation is unclear, so it is difficult to predict if or when enteroliths may form and cause bowel obstruction. More research could provide advice to prevent recurrent enterolith formation and its sequelae.

• Small bowel diverticulosis
• Jejunal diverticulosis
• Bowel obstruction
• Recurrent enterolith
• Acute care surgery
• Case report

• Bezoars
• diverticular bleeding
• faecal impaction
• foreign bodies
• gastric ulcer

• calculi
• diverticular disease
• intestinal ileus
• intestinal obstruction
• small intestine

Enterolithiasis is an uncommon medical condition. It's defined by the formation of gastrointestinal concretion in the setting of intestinal stasis. Enteroliths are typically incidentally discovered during imaging and are a rare cause of acute small bowel obstruction. We report the case of acute small bowel obstruction, secondary to primary true enterolithiasis, in a 73-year-old male, with unremarkable medical history. He presented with clinical features in keeping with acute small bowel obstruction, for 2 days. An abdominal contrast-enhanced CT scan suggested a small bowel obstruction caused by a 32mm diameter enterolith located in the terminal ileum. The surgical management was successful and consisted of the removal of the enterolith after enterotomy.

• Acute small bowel obstruction
• Idiopathic
• Imaging
• Primary true enterolithiasis

• bowel obstruction
• gallstone ileus
• intestinal obstruction
• treatment

• gastrointestinal surgery
• general surgery

• Abdomen
• Aged
• Calculi
• Diverticulum/complications
• Diverticulum/diagnostic imaging
• Diverticulum/surgery
• Female
• Humans
• Ileus/diagnostic imaging
• Ileus/etiology
• Ileus/surgery
• Intestinal Obstruction/diagnostic imaging
• Intestinal Obstruction/etiology
• Intestinal Obstruction/surgery
• Tomography, X-Ray Computed

Primary enteroliths associated with Crohn's disease have been considered to be rare and are most likely caused by severe ileal stenosis. Herein, we report the case of a primary enterolith possibly caused by mild jejunal stenosis in a Crohn's disease patient who received oral administration of ursodeoxycholic acid (UDCA). A 62-year-old woman with a 6-year history of Crohn's disease, currently in clinical remission, was on UDCA prescription for liver dysfunction. Magnetic resonance imaging and double-balloon endoscopy, which were performed to examine epigastric pain, revealed mild jejunal stenosis and an enterolith on the oral side. Since it was difficult to remove or crush the enterolith endoscopically, we decided to remove it surgically with the stenotic jejunum. Component analysis revealed that more than 98% of the enterolith was composed of UDCA; subsequently, oral administration of UDCA was discontinued. This case demonstrated that primary enterolith might develop in Crohn's disease patients with mild intestinal stenosis, and oral administration of UDCA can trigger an enterolith in such patients. Therefore, routine follow-up imaging is necessary for early detection. Oral UDCA should be administered with caution for Crohn's disease patients with stenosis of the proximal small intestine.

• Crohn's disease
• primary enterolith
• stenosis of proximal small intestine
• ursodeoxycholic acid

• Abdominal Pain
• Enterolithiasis
• Gastrointestinal Concretions

Meckel’s diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract. Its course is usually benign but may also result in complications requiring surgical intervention. A diverticulum may also permit the removal of intraluminal objects without bowel resection and anastomosis.

A woman in her 50s was found to have a mechanical small bowel obstruction secondary to an intraluminal mass within the terminal ileum. On exploration, an MD was encountered proximal to the mass. A diverticulectomy was performed after maneuvering the enterolith into the diverticulum.

Meckel’s diverticulum with an associated enterolith is a rare cause of small bowel obstruction. Historic imaging may show long-standing stones in the bowel lumen and provide a diagnostic clue. Diverticulectomy may be performed to reduce the risks of small bowel resection and anastomosis. This technique can be used for other intraluminal objects requiring removal in the presence of an MD.

• diagnosis
• gastrointestinal obstruction
• meckel´s diverticulum
• surgery general
• surgical acute abdomen

• gastrointestinal surgery
• general surgery
• small intestine

To evaluate the clinical characteristics and indications for surgery for bezoar-induced small bowel obstruction (BI-SBO).

Forty patients with BI-SBO were treated at our hospital from January 2017 to December 2019, and these patients’ clinical and computed tomography (CT) data were analyzed.

Twenty-seven and 13 BI-SBO patients constituted the non-ST group and ST group, respectively. The clinical manifestations of BI-SBO in both groups were abdominal pain, nausea, vomiting, and lack of defecation. Comparing the non-ST vs ST groups, respectively: mean age (years): 63.15 ± 16.15 vs 60.38 ± 12.47; duration of symptoms (hours): 55.11 ± 44.08 vs 59.33 ± 72.90; mean bezoar length (cm): 5.31 ± 0.74 vs 3.72 ± 0.53; mean bezoar width (cm): 3.74 ± 0.48 vs 2.9 ± 0.64; bezoar CT maximum Hounsfield units (HU): 97.23 ± 12.36 vs 21.11 ± 7.27; total hospital stay (days): 5.56 ± 4.23 vs 7.12 ± 6.12 (mean: 8.62 ± 2.81); and total hospitalization costs (RMB): 6378.02 ± 3015.68 vs 8213.71 ± 5564.29. Mean operation time was 85.00 ± 8.90 minutes, and mean operation blood loss was 32.31 ± 19.64 mL. Bezoars were located 60 to 160 cm from the ileocecal junction. Univariate analysis demonstrated that bezoar length and width and maximum CT value were significant risk factors for surgery.

Large bezoar size and high CT values may be indications for surgery. Surgery is necessary and effective when nonsurgical treatment is ineffective.

• Bezoar-induced small bowel obstruction
• clinical characteristics
• computed tomography
• hospital stay
• hospitalization costs
• surgical indications

True primary enterolithiasis is an uncommon condition, and nontraumatic perforation of the small intestine (NTPSI) is also an unusual entity. Therefore, NTPSI due to true primary enteroliths is an exceptionally rare complication. Moreover, enterolithiasis and radiation enteritis are also unique combinations. Herein, we present an exceedingly rare case of NTPSI induced by multiple true primary enteroliths associated with radiation enteritis.

A 92-year-old woman with acute abdominal pain was transferred to our hospital because a computed tomography (CT) scan performed by her family doctor revealed free air and fluid collection within her abdomen. Our initial diagnosis was upper gastrointestinal perforation, and we selected nonoperative management (NOM) with adnominal drainage. Although her general condition was stable, jejunal juice was drained continuously. Given that the CT performed 10 days after onset demonstrated perforation of the small intestine and adjacent concretion, we performed an emergency partial resection of the small intestine and jejunostomy. The resected bowel was 1 m in length and had many strictures that contained multiple enteroliths in their proximal lumens. The patient’s postoperative course was uneventful. The enteroliths were composed of deoxycholic acid (DCA). She was diagnosed with peritonitis due to NTPSI derived from multiple true primary enteroliths associated with radiation enteritis, as she had previously undergone hysterectomy and subsequent internal radiation therapy.

Clinicians should consider the rare entity of true primary enteroliths associated with radiation enteritis in NTPSI cases with unknown etiologies.

• Enterolithiasis
• Nontraumatic perforation
• Radiation enteritis
• Small bowel perforation
• True primary enterolith

• Colorectum
• Enterolith
• Subepithelial lesion

• Adult
• Calculi/diagnostic imaging
• Calculi/surgery
• Colonoscopy
• Female
• Gallstones
• Humans
• Ileocecal Valve/diagnostic imaging
• Intestinal Obstruction

• emergency
• enterolith
• obstruction
• radiation
• surgery

• gastrointestinal surgery
• general surgery
• small intestine

• Crohn’s disease
• double-balloon enteroscopy
• enterolith
• intestinal obstruction

• Bowel ischemia
• Bowel obstruction
• Loop ileostomy
• Primary enterolith

• Anemia
• Hazard ratio
• Systematic review
• Tuberculosis
• and Meta-analysis

• Anemia/epidemiology
• Anemia/etiology
• Humans
• Risk Factors
• Tuberculosis/epidemiology

• colonography
• conservative treatment
• disimpaction
• endoscopy
• fecal impaction

• enterolithiasis
• intestinal obstruction
• large bowel obstruction
• unusual

•

Bouveret’s syndrome results from biliary stones from cholecysto-duodenal fistula.

Bouveret Syndrome is a rare but important variant of gallstone ileus with high potential for morbidity and mortality. Bouveret syndrome is a complication of gallstone disease resulting from chronic inflammation and subsequent fistulization between the gallbladder and duodenum or stomach with subsequent impaction of the stone in the proximal GI tract. Here we present a case in an elderly man with moderate medical comorbidities.

An elderly man presented to the hospital with symptoms of gastrointestinal obstruction. Upon further diagnostic work-up, he was noted to have a 5.8 cm gallstone impacted in his proximal GI tract and thus diagnosed with a rare variant of gallstone ileus—Bouveret syndrome.

The therapeutic goal in approaching Bouveret syndrome is removal of the stone and improvement in obstruction and cholangitis. This may be accomplished with surgery or endoscopic therapy—although this may be less effective. Bouveret syndrome may have high morbidity.

Bouveret syndrome is a rare but potentially serious syndrome that should be managed accordingly. It should remain on the differential diagnosis of an elderly patient presenting with gastrointestinal obstructions, particularly if there is a history of gallstone disease and concern for proximal GI obstruction.

• Biliary disease
• Cholecystostomy
• Enterolithiasis
• Gallstone ileus
• Gastric outlet obstruction
• Geriatrics

Enterolithiasis associated with blind pouch syndrome secondary to functional end-to-end anastomosis is rare, and its endoscopic and radiological features remain poorly described. A 72-year-old woman was admitted to our hospital for abdominal pain and difficulty defecating. Colonoscopy (CS) with Gastrografin revealed a 10 × 8 cm calculus, an anastomotic ulcer, a blind pouch, and an end-to-end anastomosis in the transverse colon. The calculus was successfully crushed and removed with snares and alligator forceps through CS during the ensuing 4-day period. To our knowledge, this is the first report describing the endoscopic and radiological features of blind pouch syndrome-associated enterolithiasis successfully treated with CS.

• Blind pouch syndrome
• Colonoscopy
• Enterolithiasis
• Functional end-to-end anastomosis

Gastrointestinal tract (GIT) perforation is a common medical emergency associated with considerable mortality, ranging from 30 to 50%. Clinical presentation varies: oesophageal perforations can present with acute chest pain, odynophagia and vomiting, gastroduodenal perforations with acute severe abdominal pain, while colonic perforations tend to follow a slower progression course with secondary bacterial peritonitis or localised abscesses. A subset of patients may present with delayed symptoms, abscess mimicking an abdominal mass, or with sepsis.

Direct multidetector computed tomography (MDCT) findings support the diagnosis and localise the perforation site while ancillary findings may suggest underlying conditions that need further investigation following primary repair of ruptured bowel. MDCT findings include extraluminal gas, visible bowel wall discontinuity, extraluminal contrast, bowel wall thickening, abnormal mural enhancement, localised fat stranding and/or free fluid, as well as localised phlegmon or abscess in contained perforations.

The purpose of this article is to review the spectrum of MDCT findings encountered in GIT perforation and emphasise the MDCT and clinical clues suggestive of the underlying aetiology and localisation of perforation site.

• Aetiology
• Emergency
• Gastrointestinal perforation
• Multidetector computed tomography

• Gastrointestinal tract
• general surgery
• intestinal obstruction
• small intestine
• tissue adhesion

• acid-base reaction
• cola
• enterolith
• intestinal obstruction

• Aged, 80 and over
• Calculi/complications
• Calculi/drug therapy
• Cola
• Female
• Humans
• Hydrogen-Ion Concentration
• Ileus/etiology
• Intestinal Obstruction/etiology
• Intestine, Small
• Solubility

Enterolithiasis or intestinal stones are uncommonly reported. Enterostasis is the cause of stone formation mainly secondary to tuberculous strictures. Although it is unusual, enteroliths can cause intestinal obstruction. We report a case of a mechanical partial intestinal obstruction in a patient with ulcerative colitis previously treated with total colectomy, with the rare diagnosis of multiple primary enterolithiasis.

• Intestinal stones
• enterolithiasis
• mechanical intestinal obstruction
• small bowel obstruction
• stricture
• ulcerative colitis

• Abdominal wall abscess
• Enterocutaneous fistula
• Small bowel diverticulum

• TB and other respiratory infections
• tropical medicine (infectious disease)

Primary enterolithiasis is a relatively uncommon but important cause of small bowel obstruction. We present a case of a 69-year-old male with a history of laparoscopic Roux-en-Y gastric bypass and asymptomatic duodenal diverticulum diagnosed with small bowel obstruction. CT imaging showed an obstruction distal to the jejunojejunostomy, and surgical intervention was warranted. A 4.5 cm enterolith removed from the distal jejunum was found to contain 100% bile salts, consistent with a primary enterolith. Clinicians should retain a high index of suspicion for enteroliths as a cause of small bowel obstruction, especially if multiple risk factors for enterolith formation are present.