Idiopathic primary spontaneous enterolith with intestinal obstruction: A case report with a review of the literature.

Abstract

Introduction and importance: Enterolithiasis, the presence of stones within the gastrointestinal tract, is a rare condition with an incidence of 0.3 to 10 %. The incidence has increased due to advances in imaging techniques and longer life span of patients. Enteroliths are formed within areas of stasis due to various conditions. These can be primary or secondary, true or false, and can cause obstruction, perforation, or may be asymptomatic. We present an elderly female who had a history of obstruction and who, at operation, had a large stone in her intestine which was causing obstruction but had no distal stricture.

Case presentation: A 58-year-old woman who had diabetes and hypertension was admitted complaining of severe abdominal discomfort, vomiting, bloating, and constipation for 15 days. Diagnostic imaging showed gallstones and dilated small intestines. A large enterolith was discovered in the distal jejunum during surgery and was successfully removed. The patient had a smooth recovery and was discharged on the seventh day post-surgery.

Clinical discussion: Enterolithiasis, first reported by Chomelin, involves stone formation within the intestine due to stasis or altered motility. Clinical presentation varies from asymptomatic to obstruction. Diagnosis relies on imaging, though definitive identification requires stone analysis. Management includes expectant, endoscopic, or surgical approaches, depending on size and associated pathology, ensuring prevention of recurrence.

Conclusion: Enterolithiasis, although rare, has been more frequently diagnosed recently. Large stones can cause obstruction. Identifying their cause can prevent recurrences. Surgery is the primary treatment, but endoscopic techniques could offer less invasive options.