Miura Yoshikazu, Hagiwara Shin-Ichiro, Hizuka Keinosuke, Saura Ryutaro, Hata Ayaha, Maeyama Takatoshi, Etani Yuri
Department of Pediatric Gastroenterology, Nutrition and Endocrinology, Osaka Women's and Children's Hospital, 840 Murodo-cho, Izumi-shi, Osaka-fu, 594-1101, Japan.
Clin J Gastroenterol. 2025 Jun;18(3):455-458. doi: 10.1007/s12328-025-02123-0. Epub 2025 Apr 9.
Enterolithiasis is typically associated with gastrointestinal tract stasis. Here, we report on a rare case of chronic intestinal pseudo-obstruction with sand-like enterolithiasis in an 18-year-old Japanese female admitted to our hospital with high fever and abdominal pain. Despite initiating antibiotic treatment, the fever persisted. A contrast-enhanced computed tomography revealed colonic enlargement and a large amount of residue with a high-density area in the ascending colon. A colonoscopy revealed sand-like enteroliths in the ascending colon, which were drained using a colonoscope. The patient's symptoms improved significantly after the drainage and antibiotic therapy. The granules were white-brown in color and smaller than 300 μm in size. Infrared spectroscopy indicated similar peaks for crystals and hydroxypropyl cellulose which is an additive used in certain medications. We hypothesized that hydroxypropyl cellulose contributed to the formation of sand-like enteroliths in cases of severe intestinal dysmotility. Intestinal failure may cause enterolithiasis due to an unharmful additive and require careful follow-up.
肠石症通常与胃肠道淤滞有关。在此，我们报告一例罕见病例，一名18岁日本女性因高热和腹痛入院，患有沙样肠石症伴慢性肠道假性梗阻。尽管开始了抗生素治疗，但发热仍持续。增强计算机断层扫描显示结肠扩张，升结肠有大量残留物及高密度区域。结肠镜检查发现升结肠有沙样肠石，通过结肠镜进行了引流。引流和抗生素治疗后患者症状明显改善。这些颗粒呈白棕色，尺寸小于300μm。红外光谱显示晶体与羟丙基纤维素有相似的峰，羟丙基纤维素是某些药物中使用的一种添加剂。我们推测在严重肠道动力障碍的情况下，羟丙基纤维素促成了沙样肠石的形成。肠道衰竭可能因一种无害添加剂导致肠石症，需要密切随访。
