Small bowel obstruction due to a jejunal enterolith: an unusual complication of jejunal diverticulitis

Abstract

A 91-year-old woman presented with symptoms of acute bowel obstruction supported by clinical findings. A CT of the abdomen was performed which demonstrated jejunal diverticulosis with a single inflamed, wide necked diverticulum. A large enterolith was found to be impacted in the jejunum just distal to the area of inflammation resulting in small bowel obstruction. The patient underwent emergency laparotomy, which confirmed the CT findings. Small bowel resection was performed. The patient had an uneventful postoperative recovery.

Complicated jejunal diverticulitis with small bowel obstruction due to enterolith: A case report

“…While known complications include acute diverticulitis and SBO secondary to enterolith impaction, cases with both complications concurrently are infrequently reported in the literature. A review of existing literature uncovered only eight reported cases of jejunal diverticulitis with simultaneous enterolith obstruction [ 25 , [27] , [28] , [29] , [30] , [31] , [32] , [33] ], of which three involved bowel perforation ( Table 1.0 ) [ 25 , 27 , 28 ]. To the best of our knowledge, this case is unique in presenting with two sites of perforation and an obstructing enterolith.…”

“…To the best of our knowledge, this case is unique in presenting with two sites of perforation and an obstructing enterolith. All reviewed cases required operative management, with various surgical approaches employed [ 25 , [27] , [28] , [29] , [30] , [31] , [32] , [33] ].…”

Divertículo yeyunal perforado

“…En pacientes seleccionados con perforación sin obstrucción intestinal ni fistula, algunas series recientes sugieren la posibilidad de abordaje laparoscópico con drenaje y lavado 3 .…”

Primary enterolith and jejunal diverticula causing small bowel obstruction- A case report

“…Small stones typically would pass down but large ones may cause obstruction. This is called 'enterolith ileus' and is similar to gallstone ileus (4,(6)(7)(8). This phenomenon has only occasionally been reported in the surgical, gastroenterology or radiology literature, given that many clinicians/ surgeons are still unaware of this condition resulting in delayed diagnosis.…”