An unusual case of small intestinal obstruction secondary to a large primary enterolith

Abstract

Enterolithiasis is an uncommon entity in humans but frequently seen in equine mammals. A primary enterolith is a mineral concretion formed within the gastrointestinal tract due to the alteration in the anatomical integrity due to variety of conditions resulting in intestinal stasis. We report a patient with small intestinal obstruction due to a primary enterolith. A 65-year-old woman presented to the emergency department with central colicky abdominal pain, absolute constipation followed by vomiting. An enterolith located in distal ileum causing small intestinal obstruction was established with the aid of abdominal X-ray radiograph and computed tomography. Exploratory laparotomy was performed to extract the enterolith and to resect a strictured proximal jejunal segment which was suspected to be the original site of enterolith formation. Chemical analysis of the enterolith supports the speculation of a proximally formed primary enterolith eventually migrating to the site of impaction in the terminal ileum.