Enterolithiasis in jejunal diverticulosis, a rare cause of obstruction of the small intestine: a case report

Jejunal diverticula are rare and usually asymptomatic; they occur twice as frequently in men. They are discovered incidentally during small-bowel enteroclysis, CT scan or laparotomy. Complications include diverticulitis, perforation, hemorrhage and enterolith formation. Intestinal obstruction due to...

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Bibliographic Details
Published in:Wiener Klinische Wochenschrift 2005-04, Vol.117 (7-8), p.297-299
Main Authors: Kornprat, Peter, Langner, Cord, Mischinger, Hans J
Format: Article
Language:English
Subjects:
Aged
Diverticulum - complications
Diverticulum - surgery
Female
Humans
Intestinal Obstruction - etiology
Intestinal Obstruction - surgery
Jejunal Diseases - complications
Jejunal Diseases - etiology
Jejunal Diseases - surgery
Laparotomy
Lithiasis - complications
Lithiasis - surgery
Radiography, Abdominal
Tomography, X-Ray Computed
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Summary:Jejunal diverticula are rare and usually asymptomatic; they occur twice as frequently in men. They are discovered incidentally during small-bowel enteroclysis, CT scan or laparotomy. Complications include diverticulitis, perforation, hemorrhage and enterolith formation. Intestinal obstruction due to enterolithiasis is uncommon. We present the association of enterolithiasis and jejunal diverticulosis causing obstruction of the small intestine in a 74-year-old female who was admitted for abdominal cramps, nausea and vomiting. On physical examination, there was discomfort on palpation of the upper abdomen. Laboratory tests revealed mild elevation of leucocytes and C-reactive protein. CT scan demonstrated dilatated loops of proximal jejunum with thickening of the wall, suggesting ingestion of a foreign body. Clinical and radiological findings did not indicate conservative therapy; our patient underwent minilaparotomy, and pronounced jejunal diverticulosis was identified. An enterotomy was performed and a cylindrical enterolith, 10cm long and 3cm in diameter, was removed. The operative and postoperative course was uneventful. Enterolithiasis must be considered as a potential source of intestinal obstruction. The differential diagnosis should take gallstone ileus and ingestion of a foreign body into consideration. Initial therapy is nonoperative; if this management fails, surgery is indicated.
ISSN:0043-5325
1613-7671
DOI:10.1007/s00508-004-0277-8