Lee C, Menezes G. Recurrent small bowel obstruction secondary to jejunal diverticular enterolith: A case report. World J Gastrointest Surg 2022; 14(8): 849-854 [PMID: 36157365 DOI: 10.4240/wjgs.v14.i8.849]
Corresponding Author of This Article
Chanyang Lee, MBBS, MS, Department of General Surgery, Geraldton Regional Hospital, 51-85 Shenton St, Geraldton 6530, WA, Australia. chanyang1@gmail.com
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Aug 27, 2022; 14(8): 849-854 Published online Aug 27, 2022. doi: 10.4240/wjgs.v14.i8.849
Recurrent small bowel obstruction secondary to jejunal diverticular enterolith: A case report
Chanyang Lee, Geoffrey Menezes
Chanyang Lee, Geoffrey Menezes, Department of General Surgery, Geraldton Regional Hospital, Geraldton 6530, WA, Australia
Author contributions: Lee C designed and drafted the manuscript; Menezes G was the original surgeon and he reviewed and approved the manuscript for submission.
Informed consent statement: Written informed consent was obtained from the patient for the publication of this report with relevant radiographic and intraoperative images.
Conflict-of-interest statement: The authors declare that there is no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chanyang Lee, MBBS, MS, Department of General Surgery, Geraldton Regional Hospital, 51-85 Shenton St, Geraldton 6530, WA, Australia. chanyang1@gmail.com
Received: January 26, 2022 Peer-review started: January 26, 2022 First decision: March 12, 2022 Revised: March 26, 2022 Accepted: July 22, 2022 Article in press: July 22, 2022 Published online: August 27, 2022 Processing time: 209 Days and 23.1 Hours
Abstract
BACKGROUND
Small bowel diverticulosis is an uncommon condition which is usually asymptomatic and is discovered incidentally. One rare complication is enteroliths forming in the diverticula causing bowel obstruction. Only a few cases of such have been described in literature, and recurrence from this aetiology has not been reported previously. This case report outlines the management of a 68-year-old male who presented with recurrent small bowel obstruction secondary to jejunal diverticular enterolith impaction, seven months following a previous episode.
CASE SUMMARY
A 68-year-old male presented with symptoms of small bowel obstruction. Computed tomography (CT) of the abdomen demonstrated small bowel obstruction from an enterolith formed in one of his extensive jejunal diverticula. He required a laparotomy, an enterotomy proximal to the enterolith, removal of the enterolith, closure of the enterotomy, and resection of a segment of perforated ileum with stapled side-to-side anastomosis. Seven months later, he represented to emergency department with similar symptoms. Another CT scan of his abdomen revealed a recurrent small bowel obstruction secondary to enterolith impaction. He underwent another laparotomy in which it was evident that a large enterolith was impacted at the afferent limb of the previous small bowel anastomosis. A part of the anastomosis was excised to allow removal of the enterolith and the defect was closed with cutting linear stapler. In the following two years, the patient did not have a recurrent episode of enterolith-related bowel obstruction.
CONCLUSION
The pathophysiology underlying enterolith formation is unclear, so it is difficult to predict if or when enteroliths may form and cause bowel obstruction. More research could provide advice to prevent recurrent enterolith formation and its sequelae.
Core Tip: Enterolith formation in small bowel diverticula followed by impaction is a rare cause of small bowel obstruction. Small bowel diverticulosis in itself is a rather rare entity. As such, the management of this acute surgical problem can vary widely depending on the situation. Only a few case reports of this pathology have been described, and the management of this condition was variable. Of note, the management of a recurrent episode in the same patient is not previously described. This case report adds to the current knowledge base of the management of this rare pathology.
