Abstract
Diverticulosis of the small bowel, complicated by enterolith formation with ensuing obturation obstruction, was recently documented in two patients. One patient had an enterolith formed within a Meckel's diverticulum; the other had an enterolith dislodged from an acquired diverticulum. Both patients presented with signs and symptoms of acute small bowel obstruction. Only 20 such cases of bowel obstruction secondary to jejunal enterolithiasis and five cases secondary to Meckel's enterolithiasis have been reported. The mechanism of obstruction may involve local encroachment or enterolith expulsion with distal bowel obstruction, although the latter is much more common. Optimally, enteroliths are broken up and milked into the proximal colon without incising the bowel. Alternatively, the enterolith may be milked proximally to a less edematous portion of bowel and an enterotomy may be performed. At times, the primary diverticulum is resected with the contained enterolith.
Similar content being viewed by others
References
Stork A, Rothschild JE, Ochsner A. Intestinal obstruction due to intraluminal foreign bodies. Ann Surg 1939;109:844–61.
Bewes PC, Haslewood GA, Roxburgh RA. Bile-acid enteroliths and jejunal diverticulosis. Br J Surg 1966;53:709–11.
Brettner A, Euphrat EJ. Radiologic significance of primary enterolithiasis. Radiology 1970;94:283–8.
Hirschy JC, Thorpe JJ, Cortese AF. Meckel's stones: a case report. Radiology 1976;119:19–20.
Schocket E, Simon SA. Small bowel obstruction due to enterolith (bezoar) formed in a duodenal diverticulum: a case report and review of the literature. Am J Gastroenterol 1982;77:621–4.
Shapiro JH, Rubinstein B, Jacobsen HG,et al. Enteroliths in the small intestine. AJR 1956;75:343–8.
Katz I, Fischer RM. Enteroliths complicating regional enteritis: a report of two cases. AJR 1957;78:653–61.
Atwell JD, Pollock AV. Intestinal calculi. Br J Surg 1960;47:367–74.
McLaughlin SJ, Jones T. Calcific enterolith perforation: an unusual complication of small bowel anastomosis. Aust N Z J Surg 1983;53:583–5.
Singleton JM. Calcific enterolith obstruction of the intestines. Br J Surg 1970;57:234–6.
Donaldson WG. Calculi in a Meckel's diverticulum: a case report and a review. Aust N Z J Surg 1978;48:644.
Baskin RH, Mayo CW. Jejunal diverticulosis: a clinical study of 87 cases. Surg Clin North Am 1952;32:1185–96.
Palder SB, Frey CB. Jejunal diverticulosis. Arch Surg 1988;123:889–94.
Wilcox RD, Shatney CH. Surgical implications of jejunal diverticula. South Med J 1988;81:1386–91.
Williams RA, Davidson DD, Serota AI, Wilson SE. Surgical problems of diverticula of the small intestine. Surg Gynecol Obstet 1981;152:621–6.
Beal SL, Walton CB, Bodai BI. Enterolith ileus resulting from small bowel diverticulosis. Am J Gastroenterol 1987;82:162–4.
Berry DF, Willing SJ, Beers GJ. Small bowel obstruction due to enterolith: CT appearance. J Comput Assist Tomogr 1987;11:707–8.
Crane PW, Crocker PR, Levinson DA, Gilmore OJ. Enterolith ileus. J R Soc Med 1988;81:292–4.
Johnson CD. Enterolith ileus. J R Soc Med 1989;82:184.
King PM, Bird DR, Eremin O. Enterolith obstruction of the small intestine. J R Coll Surg Edinb 1985;30:269–270.
Ross CB, Richards WO, Sharp KW, Bertram PD, Schaper PW. Diverticular disease of the jejunum and its complications. Am Surg 1990;56:319–24.
Grant AB. Meckel stone ileus: a case report. Aust N Z J Surg 1981;51:77–8.
Blair J. Jejunal diverticulitis with intestinal obstruction caused by fecalith. Lancet 1959;2:87–8.
Walker WF, Kerr G, Macdonald JS. Enterolith ileus. Br J Surg 1960;48:143–5.
Mortensen PB, Anderson JC. Acute obstruction by enterolith complicating jejunal diverticulosis. Case report. Acta Chir Scand 1987;153:705–6.
Author information
Authors and Affiliations
About this article
Cite this article
Lopez, P.V., Welch, J.P. Enterolith intestinal obstruction owing to acquired and congenital diverticulosis. Dis Colon Rectum 34, 941–944 (1991). https://doi.org/10.1007/BF02049713
Issue Date:
DOI: https://doi.org/10.1007/BF02049713