Brawermann Romane, Claeys Nicolas, Cappeliez Olivier, Pather Sanjiva, Saliba Tom
Surgery, Hôpital de Braine-L'Alleud, Braine-L'Alleud, BEL.
Radiology, Hôpital de Braine-L'Alleud, Braine-L'Alleud, BEL.
Cureus. 2024 Sep 29;16(9):e70451. doi: 10.7759/cureus.70451. eCollection 2024 Sep.
Proximal jejunal enteroliths, a rare form of small bowel pathology, involve calculi formation within the proximal ileum, leading to complications such as bowel obstruction and perforation. Due to their rarity and nonspecific presentation, enteroliths pose diagnostic and management challenges for clinicians. A 73-year-old male with a history of small intestinal bacterial overgrowth was admitted with acute abdominal pain, small bowel obstruction, and hypovolemic haemorrhagic shock. Despite initial stabilization, worsening symptoms led to a CT scan revealing small bowel perforation and enterolith-induced occlusion. Surgery confirmed purulent peritonitis, necessitating resection of the affected bowel segment. Enteroliths can form in diverticula due to bowel content stagnation, causing symptomatic obstruction or perforation. Management typically involves surgical intervention. The prognosis depends on timely diagnosis and treatment to prevent severe complications. Proximal jejunal enteroliths, though rare, should be considered in patients with small bowel obstruction symptoms, particularly those with a history of diverticulosis. Early recognition and appropriate management are crucial for favourable outcomes.
近端空肠肠石是一种罕见的小肠病理形式,涉及回肠近端结石形成,可导致肠梗阻和穿孔等并发症。由于其罕见性和非特异性表现,肠石给临床医生带来了诊断和管理挑战。一名73岁有小肠细菌过度生长病史的男性因急性腹痛、小肠梗阻和低血容量性失血性休克入院。尽管最初病情稳定,但症状恶化导致CT扫描显示小肠穿孔和肠石引起的梗阻。手术证实为化脓性腹膜炎,需要切除受影响的肠段。由于肠内容物停滞,肠石可在憩室内形成,导致有症状的梗阻或穿孔。治疗通常需要手术干预。预后取决于及时诊断和治疗以预防严重并发症。近端空肠肠石虽然罕见,但对于有小肠梗阻症状的患者,尤其是有憩室病病史的患者,应予以考虑。早期识别和适当管理对于取得良好预后至关重要。