A case of enterolith ileus successfully treated with colonoscopy

Abstract

A 72-year-old man was admitted to hospital with abdominal pain and constipation. Physical examination revealed abdominal distension and mild tenderness in the periumbilical area. Abdominal X-ray and computed tomography (CT) showed dilated bowel loops and air-fluid levels accompanied by a calcified mass of approximately 40mm in diameter located in the descending colon. About 9 months previously, abdominal CT had demonstrated stone impaction of a similar size in the cecum, but this was not observed on abdominal CT at admission. Bowel obstruction related to the enterolith was suspected, and an emergency colonoscopy was performed. The enterolith was endoscopically fractured and removed from the descending colon, using grasping forceps and a polypectomy snare. In addition, gastrografin enema led to the detection of a giant diverticulum in the cecum. The final diagnosis was bowel obstruction due to an enterolith expelled from a giant cecal diverticulum. There have been few reports of enterolith ileus successfully treated with colonoscopy, and this case suggests that endoscopy may be an effective, non-invasive treatment option for enteroliths.