Abdominal pain and faeculent vomiting in a 64-year-old woman

Abstract

SUMMARYA 64-year-old woman with a previous right colectomy presented with severe epigastric abdominal pain and nausea of several weeks' duration, which then escalated to projectile faeculent emesis. During her clinical course, she remained afebrile with normal vital signs. Physical examination revealed abdominal distension, moderate tenderness in the bilateral upper quadrants and provoked voluntary abdominal wall guarding. Haematology and laboratory chemistries were only notable for a mild (14.6 K/μL) leucocytosis. Acute abdominal plain radiological series revealed dilated small bowel loops and possible pneumoperitoneum. Abdominal CT demonstrated a mechanical small bowel obstruction and no extraluminal air. An exploratory laparotomy was performed, revealing an obstructing enterolith related to actively inflamed jejunal diverticulitis (complicated JD). This case report aims to describe the non-specific presentation of a poorly understood disease entity that presents a diagnostic and therapeutic challenge for the medical community. BACKGROUND

Cola Dissolution Therapy via Ileus Tube Was Effective for Ileus Secondary to Small Bowel Obstruction Induced by an Enterolith

“…Several previous studies have described the extremely rare obstruction of the small intestine due to stone impaction (4,5). Recent reports have stated that enteroliths are most often diagnosed at laparotomy because they are rarely detectable radiographically unless they are calcified (3,6,7). As a result, intestinal stones are most likely to be removed surgically.…”