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Table of Contents
Vol. 20, No. 1, 2003
Issue release date: 2003
Section title: Case Reports
Dig Surg 2003;20:57–60
(DOI:10.1159/000068852)

Enterolith Ileus as a Complication of Jejunal Diverticulosis

Two Case Reports and a Review of the Literature

Steenvoorde P. · Schaardenburgh P. · Viersma J.H.
Department of Surgery, Spaarne Hospital, Haarlem, The Netherlands

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Article / Publication Details

First-Page Preview
Abstract of Case Reports

Received: 12/6/2001
Accepted: 5/5/2002
Published online: 3/17/2003

Number of Print Pages: 4
Number of Figures: 0
Number of Tables: 2

ISSN: 0253-4886 (Print)
eISSN: 1421-9883 (Online)

For additional information: http://www.karger.com/DSU

Abstract

Background: In a period of 5 years, 2 patients with enterolith ileus, caused by jejunal diverticulosis, were treated in our hospital. In order to learn more about treatment options, the literature was reviewed. Methods: The case history of the 2 patients is described. Relevant articles were identified using Medline® and PubMed®. Data regarding patient gender, age, operative findings, therapeutic measures and outcome were collected. Results: Including patients reported in the literature, 34 cases of intestinal obstruction due to enteroliths expelled from jejunal diverticula were identified. A distinction is made between complicated and uncomplicated enterolith ileus. If there are signs of bowel ischemia, other (unborn) enteroliths, inflammation of the bowel or if there are signs of a (sealed) perforation, the case is considered a complicated enterolith ileus. If none of these signs are present, uncomplicated enterolith ileus is present. In uncomplicated enterolith ileus (21 patients), more often milking and crushing or enterotomy was performed. In complicated enterolith ileus (13 patients), more often a segmental resection of the involved jejunum was performed (p < 0.01). Conclusion: Small bowel obstruction due to enteroliths expelled from jejunal diverticula is a rare condition. Relevant literature is only available in the form of case reports. On the basis of the presented patients and patients reported in the literature, a justifiable therapeutic strategy is presented. The least invasive step in the therapeutic approach is to crush and milk the obstructing enterolith down to the colon. Laparoscopic crushing and milking of the enterolith is described. If this fails an enterotomy could be tried, if possible proximal or distal from the obstruction site, in order to make an incision in a less edematous area. If the first two strategies fail, or if complicated enterolith ileus is present, resection of the involved jejunal segment could be considered.


  

Author Contacts

P. Steenvoorde, MD, MA, Rijnland Hospital, Department of Surgery
Simon Smitweg 1, 2353 GA Leiderdorp, Postbus 4220 (The Netherlands)
Tel. +31 71 582 82 82, E-Mail P.Steenvoorde@Rijnland.nl

  

Article Information

Number of Print Pages : 4
Number of Figures : 0, Number of Tables : 2, Number of References : 41

  

Publication Details

Digestive Surgery
Official Publication of the International Society for Digestive Surgery (ISDS, formerly CICD), European Digestive Surgery (EDS), Dutch Society of Gastro-Intestinal Surgery (NVGIC), Japanese Society of Gastroenterological Surgery (JSGS), Hellenic Society for Digestive Surgery (HSDS)

Vol. 20, No. 1, Year 2003 (Cover Date: 2003)

Journal Editor: M.W. Büchler, Heidelberg; J.P. Neoptolemos, Liverpool
ISSN: 0253–4886 (print), 1421–9983 (Online)

For additional information: http://www.karger.com/dsu


Article / Publication Details

First-Page Preview
Abstract of Case Reports

Received: 12/6/2001
Accepted: 5/5/2002
Published online: 3/17/2003

Number of Print Pages: 4
Number of Figures: 0
Number of Tables: 2

ISSN: 0253-4886 (Print)
eISSN: 1421-9883 (Online)

For additional information: http://www.karger.com/DSU


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