Enterolithiasis-associated ileus in Crohn's disease

Abstract

Stasis of the flow of the intestinal contents, ingested material and unfavorable composition of the chylus can lead to the formation of enteroliths inside the bowel. Enterolithiasis represents a rare disorder of the gastrointestinal tract that can be associated with intermittent abdominal pain or more serious complications such as bleeding or obstruction. Enterolithiasis in Crohn's disease represents an extremely rare condition and usually occurs only in patients with a long symptomatic history of Crohn's disease. We report an unusual case of enterolithiasis-related intestinal obstruction in a young male patient with Crohn's disease (A2L3B1 Montreal Classification for Crohn's disease 2005) undergoing emergency laparotomy and ileocoecal resection. In addition, we present an overview of the relevant characteristics of enterolithiasis on the basis of the corresponding literature.

Keywords: Crohn’s disease; Enterolithiasis; Ileus; Inflammatory bowel disease; Obstruction.

Figure 1

X-ray of the abdomen with two small radiopaque enteroliths in the lower abdomen. A: Overall picture; B: Enlarged detail. L: Left.

Figure 2

Computed tomography images with two radiopaque enteroliths.

Figure 3

Intraoperative illustration of the small bowel ileus with evident stenosis and prestenotic dilation.

Figure 4

Resected specimen of the cecum and small bowel with two fixed enteroliths causing small bowel obstruction.

Figure 5

Typical images of enteroliths. A: Long-standing enterolith with blank-looking polished surface; B: Emerging enterolith with a rough and fragile surface.