Bruni Roberto, Chirco Luigi, Lemeni Alessandro Rossi, Petrocca Sergio
U.O. di Chirurgia Generale e d'Urgenza Policlinico Casilino Azienda U.S.L. RM B, Roma.
Chir Ital. 2002 Nov-Dec;54(6):903-5.
Small bowel obstruction is most frequently due to postoperative or inflammatory adhesions, intestinal neoplasms, hernias, or bezoars. Intermittent small bowel obstruction may be secondary to a Crohn's disease stricture or to chronic adhesive peritonitis. Enterolithiasis, usually associated with jejunal diverticulosis or with a Meckel diverticulum, should be considered in patients who have not previously undergone abdominal surgical procedures. X-ray evidence of stones in the abdominal field, outside the common sites, i.e. gallbladder, kidney, bladder, should suggest a diagnosis of enterolithiasis. The authors report a case of multiple enteroliths in a patient with a segmental ileal stricture and ulcerations (diagnosed as Crohn's disease) causing frequent, intermittent occlusive symptoms, treated by segmental ileal resection.
小肠梗阻最常见的原因是术后粘连或炎性粘连、肠道肿瘤、疝气或胃石。间歇性小肠梗阻可能继发于克罗恩病狭窄或慢性粘连性腹膜炎。肠石症通常与空肠憩室病或梅克尔憩室有关，对于未曾接受过腹部手术的患者应予以考虑。腹部平片显示在非常见部位（即胆囊、肾脏、膀胱）出现结石，应提示肠石症的诊断。作者报告了一例患有节段性回肠狭窄和溃疡（诊断为克罗恩病）的患者，因多发肠石导致频繁的间歇性梗阻症状，最终通过节段性回肠切除术进行治疗。
