Jejunal diverticular disease with unborn enterolith presenting as a small bowel obstruction: a case report.
Jejunal diverticuli are rare and usually asymptomatic. More commonly, they are seen as incidental findings on CT images, enteroclysis, or during surgery. Complications such as bleeding, perforation, obstruction, malabsorption, diverticulitis, blind loop syndrome, volvulus, and intussusception may warrant surgical intervention. An interesting case of an unborn enterolith (enclosed calculus) from a jejunal diverticulum presenting as a small bowel obstruction is presented. The patient is a 66-year- old woman with no prior history of abdominal surgery who presented with a high-grade bowel obstruction. CT with intravenous barium contrast confirmed the presence of a transition point from dilated to decompressed small bowel in the mid jejunum. At laparotomy, a freely mobile mass was found in this area leading to the bowel obstruction. The mass was removed by making a small enterotomy in the jejunum. While running the small bowel proximally, a small segment of jejunum, approximately 8 cm, containing several diverticuli was found. This bowel obstruction was the result of an unborn enterolith from this segment of bowel. The patient's hospitalization was benign and she was discharged home on postoperative day 4.
Crace
Phillip P
PP
Department of Surgery, Good Samaritan Hospital, Cincinnati, Ohio 45220, USA. amy_engel@trihealth.com
Grisham
Andre
A
Kerlakian
George
G
D000368:Aged; D002137:Calculi / Q000175:diagnosis* / Q000601:surgery*; D003937:Diagnosis, Differential; D004240:Diverticulum / Q000175:diagnosis* / Q000601:surgery*; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis* / Q000601:surgery*; D007421:Intestine, Small; D007579:Jejunal Diseases / Q000175:diagnosis* / Q000601:surgery*; D014057:Tomography, X-Ray Computed