Enterolith with enterocolic fistula: the diagnostic approach

Abstract

An enterolith is a mixed concretion formed in GIT, usually rare in humans. Primary enteroliths are formed in small bowel, typically within a diverticulum and secondary enteroliths in gallbladder. This case report highlights the presence of an enterocolic fistula; probably a postradiotherapy complication; and an enterolith without associated small bowel or colonic diverticuli. We have discussed the various diagnostic modalities used to reach a preoperative diagnosis of this rare condition. Imaging plays an important role in the detection and management of acquired gastrointestinal fistulas. The more routine use of cross-sectional imaging (especially computed tomography and magnetic resonance imaging) has altered the standard sequence of radiologic evaluation for possible fistulas, but fluoroscopic studies remain a valuable complement, especially for confirming and defining the anomalous communications.

Figure 1

CT scan indicating a mass with peripheral calcification.

Figure 2

Barium enema showing an entero-colic fistula with an enterolith at the site of the fistula

Figure 3

Segmental enterectomy with sigmoidectomy specimen with enterolith