A Case Report of Ileus Caused by a True Enterolith

Abstract

We report a case of ileus caused by a true enterolith. An 85-year-old man visited our hospital with the chief complaints of abdominal pain and vomiting. The patient had no history of abdominal surgery. An abdominal plain CT revealed a structure with a cavity in the small intestine and dilated small bowel on the oral side of this structure. Laparoscopic-assisted surgery was performed on Day 2 of hospitalization based on the diagnosis of ileus caused by a dietary substance or foreign body. We pulled out a stone-like foreign body with good mobility by enterotomy from the small intestine, approximately 120 cm from the ligament of Treitz, and extracted it via a mini-laparotomy through the umbilicus. The ‘foreign body’ was a yellowish enterolith measuring 35×23mm (9.0 g). Chemical analysis revealed that the enterolith partially consisted of deoxycholic acid, and the patient was finally diagnosed as having ileus caused by a bile acid enterolith, one of the true enteroliths.