True enteroliths linked to non-specific multiple ulcers of the small intestine: report of a case
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This report presents a case of true enteroliths linked to non-specific multiple ulcers of the small intestine (CNSU). A 53-year-old male presented with abdominal pain and vomiting, and was admitted to our hospital under a diagnosis of ileus. He had anemia and hypoalbuminemia. Abdominal computed tomography showed that several radio-opaque bodies were present in the dilated small intestine. Double-balloon enteroscopy revealed an eccentric stricture accompanying a linear open ulcer. Well defined oblique and branching ulcers were continuous with the stricture. At laparotomy, we observed 18 stenoses of the small intestine from 190 cm to 110 cm proximal to the ileocecal valve. The stenotic and dilated segments were 1.7 ± 0.4 and 5.4 ± 3.0 (mean ± SD) cm in width, respectively. He underwent a resection of the affected small intestine. The macroscopic observation revealed various types of multiple shallow ulcers that were linear or had a tall, triangular configuration, and their alignment was circular or oblique. The ulcers had fused, thus showing a geographic configuration. The microscopic findings showed the maximum depth of the ulcers to be the submucosal layer. The enteroliths were mainly composed of calcium oxalate. As a result, the patient was diagnosed as having true enteroliths linked to CNSU. True enteroliths are a rare complication of CNSU.
KeywordsNon-specific multiple ulcers of the small intestine True enteroliths Small intestinal ulcer Double-balloon enteroscopy
Conflict of Interest: Hirotsugu Morioka, Yuya Ueda, Tomohiko Nishihira, Tetsuro Ogino Akihiro Miki, Shinichiro Yoshitani, Yasuhide Ishikawa, Mitsushige Shibatoge, and Tetsuro Hirose declare that they have no conflict of interest.
Human/Animal Rights: All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008(5).
Informed Consent: Informed consent was obtained from all patients included in the study.
- 2.Shut JM, Mallens WMC. Calcified enteroliths in regional enteritis. Diagn Imag Clin Med. 1986;55:146–50.Google Scholar
- 4.Okabe H, Sakimura M. Nonspecific multiple ulcer of the small intestine (in Japanese with English abstract). Stom Int. 1968;3:1539–49.Google Scholar
- 5.Hirai F, Matsui T. Chronic hemorrhagic ulcers of the small intestine. Stom Int. 2008;43:603–9.Google Scholar
- 10.Hirai, et al. Chronic hemorrhagic ulcers of the small intestine. Stom Int. 2008;43(4):603–10.Google Scholar
- 11.Matsumoto, et al. Enteroscopic features of chronic nonspecific multiple ulcers of the small intestine: comparison with nonsteroidal anti-inflammatory drug induced enteropathy. Stom Int. 2006;41(2):1637–48.Google Scholar