Enteroliths of small bowel diverticula

Herbetko, J.; Brunton, F.J.

doi:10.1016/s0009-9260(05)80536-7

Cited by 13 publications

(11 citation statements)

References 7 publications

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“…Clinically, the length of the involved segment could be longer than 10 cm [9] . SBO resulted from BZ is usually due to migration of gastric BZ [6,14] , however the obstruction could also be caused by primary BZs formed in small bowel in association with underlying diseases such as diverticulum, stricture or tumor [9,[26][27][28] . Previous gastric surgery resulting in widened gastric outlet might permit BZ migration into the small bowel [11] .…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal bezoars: A retrospective analysis of 34 cases

Erzurumlu

Malazgirt²,

Bektaş³

et al. 2005

WJG

177

181

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AIM: Bezoars (BZ) are the most common foreign bodies of gastrointestinal tract. Clinical manifestations vary depending on the location of BZ from no symptoms to acute abdominal syndrome. When located in small bowel, they frequently cause small bowel obstruction (SBO). We aimed to present our experience by reviewing literature. METHODS:Thirty-four patients with gastrointestinal BZ were presented. The data were collected from hospital records and analyzed retrospectively. Morbidity and mortality rates were statistically analyzed between the subgroups according to SBO and endoscopic or surgical treatment modalities. RESULTS:The 34 patients had phytobezoars (PBZ). Two patients with mental retardation and trichotillomania had trichobezoars (TBZ). More than half of them (55.88%) had previous gastric surgery. Also most of them had small bowel bezoars resulting in obstruction. Surgical and endoscopic morbidity rates were 32.14% and 14.28% respectively. The total morbidity rate of this study was 29.41%. Four patients in surgically treated group died. There was no death in endoscopically treated group. The total and surgical mortality rates were 11.76% and 14.28% respectively. The differences in morbidity and mortality rates between the subgroups were not statistically significant. CONCLUSION:BZ are commonly seen in stomach and small intestine. SBO is the most common complication. When uncomplicated, endoscopic or surgical removal can be applied easily.

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Section: Discussionmentioning

confidence: 99%

Gastrointestinal bezoars: A retrospective analysis of 34 cases

Erzurumlu

Malazgirt²,

Bektaş³

et al. 2005

WJG

177

181

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“…The remaining 12 articles report on 24 cases of which 11 are of obstruction without perforation, 10 are cases of perforation at the site of jejunal diverticulum and 3 report perforation at a site distant to the diverticulum,7 16 17 as was the case in this patient.…”

Section: Discussionmentioning

confidence: 78%

Small bowel obstruction and perforation secondary to primary enterolithiasis in a patient with jejunal diverticulosis

Chaudhery¹,

Newman²,

Kelly³

2014

BMJ Case Reports

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We describe a rare case of small bowel obstruction and perforation secondary to a primary enterolith in an 84-year-old female patient with jejunal diverticulosis. She underwent an emergency laparotomy, small bowel resection and primary anastomosis. Multiple jejunal diverticula and a large stone were identified at the time of operation. Analysis of the stone demonstrated mainly faecal material consistent with a true primary enterolith. A literature search of Medline and PubMed revealed three cases similar to the one described. The pathogenesis and management of enterolithiasis in jejunal diverticular disease is considered.

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“…Including the herein presented cases, a total of 34 patients have been reported up to now [2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27]. Table 1 lists the relevant information available on all patients with enterolith ileus as a complication of jejunal diverticulosis.…”

Section: Resultsmentioning

confidence: 99%

Enterolith Ileus as a Complication of Jejunal Diverticulosis

Steenvoorde¹,

Schaardenburgh²,

Viersma³

2003

Dig Surg

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Background: In a period of 5 years, 2 patients with enterolith ileus, caused by jejunal diverticulosis, were treated in our hospital. In order to learn more about treatment options, the literature was reviewed. Methods: The case history of the 2 patients is described. Relevant articles were identified using Medline^® and PubMed^®. Data regarding patient gender, age, operative findings, therapeutic measures and outcome were collected. Results: Including patients reported in the literature, 34 cases of intestinal obstruction due to enteroliths expelled from jejunal diverticula were identified. A distinction is made between complicated and uncomplicated enterolith ileus. If there are signs of bowel ischemia, other (unborn) enteroliths, inflammation of the bowel or if there are signs of a (sealed) perforation, the case is considered a complicated enterolith ileus. If none of these signs are present, uncomplicated enterolith ileus is present. In uncomplicated enterolith ileus (21 patients), more often milking and crushing or enterotomy was performed. In complicated enterolith ileus (13 patients), more often a segmental resection of the involved jejunum was performed (p < 0.01). Conclusion: Small bowel obstruction due to enteroliths expelled from jejunal diverticula is a rare condition. Relevant literature is only available in the form of case reports. On the basis of the presented patients and patients reported in the literature, a justifiable therapeutic strategy is presented. The least invasive step in the therapeutic approach is to crush and milk the obstructing enterolith down to the colon. Laparoscopic crushing and milking of the enterolith is described. If this fails an enterotomy could be tried, if possible proximal or distal from the obstruction site, in order to make an incision in a less edematous area. If the first two strategies fail, or if complicated enterolith ileus is present, resection of the involved jejunal segment could be considered.

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Enteroliths of small bowel diverticula

Cited by 13 publications

References 7 publications

Gastrointestinal bezoars: A retrospective analysis of 34 cases

Gastrointestinal bezoars: A retrospective analysis of 34 cases

Small bowel obstruction and perforation secondary to primary enterolithiasis in a patient with jejunal diverticulosis

Enterolith Ileus as a Complication of Jejunal Diverticulosis

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