Efremidou Eleni I, Liratzopoulos Nikolaos, Papageorgiou Michalis S, Kouklakis George, Minopoulos Georgios J, Manolas Konstantinos J
First Department of Surgery, University General Hospital of Alexandroupolis, Medical School of Democritus, University of Thrace, Dragana, 68100, Alexandroupolis, Greece.
Surg Today. 2006;36(11):1003-6. doi: 10.1007/s00595-006-3283-9.
We report the successful surgical treatment of intestinal obstruction caused by enteroliths formed in jejunal diverticula. A 78-year-old man with bowel obstruction of unknown etiology was initially managed conservatively, but suffered recurrence of the obstruction. Thus, we performed a laparotomy, which revealed multiple diverticula in the jejunum, with one enterolith inside a diverticulum and one enterolith in the terminal ileum. There was no abnormal communication between the gallbladder and the intestinal tract, excluding the possibility of a gallstone ileus. The stone in the terminal ileum could not be broken manually, so we performed an enterotomy to remove the stones. Intestinal obstruction caused by enteroliths in small-bowel diverticula is a rare event, which is difficult to diagnose and manage. To our knowledge, only 35 such cases have ever been reported.
我们报告了因空肠憩室形成肠石导致肠梗阻的成功手术治疗病例。一名78岁病因不明的肠梗阻男性患者最初接受了保守治疗,但梗阻复发。因此,我们进行了剖腹手术,发现空肠有多个憩室,一个憩室内有一枚肠石,回肠末端有一枚肠石。胆囊与肠道之间没有异常连通,排除了胆结石性肠梗阻的可能性。回肠末端的结石无法手动破碎,因此我们进行了肠切开术以取出结石。小肠憩室中的肠石导致的肠梗阻是一种罕见情况,难以诊断和处理。据我们所知,此前仅报道过35例此类病例。