A case of true enteroliths with peculiar local dilatation of the ileum

Abstract

An 89-year-old man was seen at the hospital because of gradually intensifying lower abdominal pain. An abdominal CT scan revealed a localized dilatation of the ileum with the maximum diameter of about 13cm associated with gross calcification in its inner portion. Meckel's diverticulum was initially suspected and the patient was operated on. Upon laparotomy, we saw a cystic dilatation of the intestine distal to the anastomosis due to the previous partial resection of the small intestine for intestinal obstruction caused by a parasite done in 1961. In addition three enteroliths 4cm in diameter were present in the lumen of the dilated intestine. An analysis of components of the enteroliths disclosed that they were true enteroliths mainly consisted of calcium oxalate.
True enterolith is a relatively rare entity and so far only 46 cases of true enterolith have been reported in Japan. This case is also discussed in terms of its peculiar morphology of cystic dilatation of the ileum distal to the anastomosis.