de Silva G P U P, Rathnasena B G N, Karunadasa M S E
Postgraduate Institute of Medicine, University of Colombo, Colombo, Sri Lanka.
Department of Surgery, National Hospital of Sri Lanka, Colombo, Sri Lanka.
SAGE Open Med Case Rep. 2023 Jul 13;11:2050313X231185952. doi: 10.1177/2050313X231185952. eCollection 2023.
Enterolithiasis is an uncommon entity in humans but frequently seen in equine mammals. A primary enterolith is a mineral concretion formed within the gastrointestinal tract due to the alteration in the anatomical integrity due to variety of conditions resulting in intestinal stasis. We report a patient with small intestinal obstruction due to a primary enterolith. A 65-year-old woman presented to the emergency department with central colicky abdominal pain, absolute constipation followed by vomiting. An enterolith located in distal ileum causing small intestinal obstruction was established with the aid of abdominal X-ray radiograph and computed tomography. Exploratory laparotomy was performed to extract the enterolith and to resect a strictured proximal jejunal segment which was suspected to be the original site of enterolith formation. Chemical analysis of the enterolith supports the speculation of a proximally formed primary enterolith eventually migrating to the site of impaction in the terminal ileum.
肠结石症在人类中并不常见，但在马科哺乳动物中却很常见。原发性肠结石是由于各种导致肠道淤滞的情况引起解剖结构完整性改变，从而在胃肠道内形成的矿物质凝结物。我们报告一例因原发性肠结石导致小肠梗阻的患者。一名65岁女性因中央绞痛性腹痛、完全便秘继以呕吐就诊于急诊科。借助腹部X线平片和计算机断层扫描确定一枚位于回肠末端的肠结石导致小肠梗阻。进行了剖腹探查术以取出肠结石，并切除一段疑似肠结石形成原发部位的近端空肠狭窄段。对肠结石的化学分析支持了原发性肠结石最初在近端形成，最终迁移至回肠末端梗阻部位的推测。
