Журнал клинических случаев

A Case Study of Intestinal Obstruction Associated with True Primary Enteroliths in an Elderly Patient

Abstract

Hiroyuki Inoue, Mahito Miyamae, Takuma Arai, Yozo Kokawa and Eigo Otsuji

Enteroliths are generally classified as ‘true’ or ‘false’ enteroliths and most cases involve the latter, with ‘true’ enteroliths being rare. In addition, Enteroliths are often asymptomatic and unlikely to cause intestinal obstruction or perforations. The following is a very rare case of intestinal obstruction accompanied by true enteroliths suffered by a very elderly patient. We report the case of 96-year-old female with loss of appetite and abdominal pain. A Computed Tomography (CT) confirmed enteroliths and Press through Packages (PTP) near the terminal ileum. Moreover, the intestinal tract closest to the mouth was enlarged. A diagnosis was made of an intestinal obstruction caused by the enteroliths and so emergency surgery was carried out. We found the existence of stenosis with incarcerated enteroliths found in the intestinal tract adjacent to the mouth. A piece of the small intestine was therefore removed. Upon analysis of the sample, four intestinal stones plus PTP were found. The main component of the enteroliths was determined to be deoxycholic acid upon analysis of their makeup and we thought the sample stones as true enteroliths. The post-operative course went well and the patient was able to return home on the 37th day of hospitalization. Cases of intestinal obstruction due to true enteroliths have a low likelihood of the stones being passed naturally. Thus, it is advisable that surgery be performed as soon as the corresponding diagnosis is made.