Abstract
A 66-year-old woman was seen at the emergency department in our hospital because of nausea and left lower abdominal pain. An abdominal plain X-ray film showed the distended transverse colon, gas accumulation in the small intestine, and a calcified shadow of pproximately 5cm in diameter corresponding to the site of the pain. Abdominal CT scan demonstrated a calcified, laminated intestinal stone of approximately 5cm in diameter in the descending colon. On gastrografin enema examination, gastrografin failed to flow in the intestine proximal to the stone in the descending colon, and the abdominal pain persisted. Colonic obstruction from intestinal calculus was thus diagnosed, and emergency surgery was performed. Laparotomy revealed a hard, palpable intestinal stone. The intestine proximal to the stone was distended. We incised the descending colon, and removed the stone. It measured 6×6×5cm, was spherical and hard, and had a dark-brown, rough surface. On sectioning, the stone contained many grayish-white stones of approximately 5mm in diameter in the laminated structure. Chemical analysis showed that the stone was composed of 88% fatty acid calcium and 12% calcium phosphate. We speculate that chronic constipation and a long history of ingestion of calcium carbonate might contribute to formation of the intestinal stone.
