Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, 110 Inthawarorot Rd., Sriphum, Muang, Chiang Mai, 50200, Thailand.
Lampang Hospital, Lampang, Thailand.
Clin J Gastroenterol. 2021 Jun;14(3):765-768. doi: 10.1007/s12328-021-01357-y. Epub 2021 Mar 23.
A 32-year-old woman presented with chronic constipation for three years. Colonoscopy revealed a 2.5 cm subepithelial tumor-like lesion at the ileocecal (IC) valve with protrusion of the lesion into the lumen. A CT scan of the abdomen showed an oval-shape laminated calcified lesion adhered to the IC valve and several gallstones. An exploratory laparotomy to enterotomy with stone extraction and open cholecystectomy was performed. Operative findings showed stone erosion into the ileal wall with the lesion being covered with colonic mucosa. Pathologic examination of stones from the intestinal wall revealed an enterolith. The case exemplifies the infrequent cause of a subepithelial lesion of the gastrointestinal tract and a rare presentation of an enterolith as a subepithelial lesion within the terminal ileal wall.
一位 32 岁女性因慢性便秘就诊，病史三年。结肠镜检查发现回盲瓣有一 2.5cm 黏膜下肿瘤样隆起性病变，病变向管腔突出。腹部 CT 扫描显示回盲瓣有一卵圆形层状钙化病变，附着于回盲瓣，伴多发胆囊结石。行剖腹探查，术中行肠切开取石及胆囊开放性切除术。术中发现结石侵蚀回肠壁，病变被结肠黏膜覆盖。肠壁结石的病理检查提示为肠石。该病例提示了胃肠道黏膜下病变的罕见病因，以及肠石作为末端回肠壁黏膜下病变的罕见表现。
