A CASE OF SMALL BOWEL OBSTRUCTION DUE TO BILE ACID ENTEROLITH

Abstract

An 80-year-old woman was emergently transferred to the hospital because intermittent abdominal pain around the navel became lasting. Plain abdominal X-ray film revealed small intestinal gas due to obstruction. An exploration of the small intestine by gastrograffin showed a filling defect 4cm in diamter and smooth margin in the small intestine. Abdominal ultrasonography and computed tomography showed a calculus in the small intestine measuring 4cm in diameter. Natural discharge of the obstruction was difficult and surgical treatment was conducted with a diagnosis of the excrement stone or foreign body of hte small intestine. A change in color in a part of ileum, which was in the same location of the lump, was recognized inthe distance of 110cm from the terminal ileum. Partial ilectomy was performed. the lump was 4cm in diameter, 25g in weight, and dark brown in color, and a profit side presented an annual rign structure. The enterolith consisting of bile acid element is rare.