title: True enteroliths linked to non-specific multiple ulcers of the small intestine: report of a case.
abstract: This report presents a case of true enteroliths linked to non-specific multiple ulcers of the small intestine (CNSU). A 53-year-old male presented with abdominal pain and vomiting, and was admitted to our hospital under a diagnosis of ileus. He had anemia and hypoalbuminemia. Abdominal computed tomography showed that several radio-opaque bodies were present in the dilated small intestine. Double-balloon enteroscopy revealed an eccentric stricture accompanying a linear open ulcer. Well defined oblique and branching ulcers were continuous with the stricture. At laparotomy, we observed 18 stenoses of the small intestine from 190 cm to 110 cm proximal to the ileocecal valve. The stenotic and dilated segments were 1.7 ± 0.4 and 5.4 ± 3.0 (mean ± SD) cm in width, respectively. He underwent a resection of the affected small intestine. The macroscopic observation revealed various types of multiple shallow ulcers that were linear or had a tall, triangular configuration, and their alignment was circular or oblique. The ulcers had fused, thus showing a geographic configuration. The microscopic findings showed the maximum depth of the ulcers to be the submucosal layer. The enteroliths were mainly composed of calcium oxalate. As a result, the patient was diagnosed as having true enteroliths linked to CNSU. True enteroliths are a rare complication of CNSU.
authors.affiliation: Department of Gastroenterological Surgery, Takamatsu Red Cross Hospital, 4-1-3 Banchou, Takamatsu city, Kagawa prefecture, 760-0017, Japan. hirotsugu0419@gmail.com.
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Morioka
authors.affiliation: Division of Gastroenterology, Takamatsu Red Cross Hospital, Takamatsu city, Japan.
authors.forename: Yuya
authors.initials: Y
authors.lastname: Ueda
authors.affiliation: Department of Gastroenterological Surgery, Takamatsu Red Cross Hospital, 4-1-3 Banchou, Takamatsu city, Kagawa prefecture, 760-0017, Japan.
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Nishihira
authors.affiliation: Department of Pathology, Takamatsu Red Cross Hospital, 4-1-3 Banchou, Takamatsu city, Kagawa prefecture, 760-0017, Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Ogino
authors.affiliation: Department of Gastroenterological Surgery, Takamatsu Red Cross Hospital, 4-1-3 Banchou, Takamatsu city, Kagawa prefecture, 760-0017, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Miki
authors.affiliation: Department of Gastroenterological Surgery, Takamatsu Red Cross Hospital, 4-1-3 Banchou, Takamatsu city, Kagawa prefecture, 760-0017, Japan.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Yoshitani
authors.affiliation: Department of Gastroenterological Surgery, Takamatsu Red Cross Hospital, 4-1-3 Banchou, Takamatsu city, Kagawa prefecture, 760-0017, Japan.
authors.forename: Yasuhide
authors.initials: Y
authors.lastname: Ishikawa
authors.affiliation: Division of Gastroenterology, Takamatsu Red Cross Hospital, Takamatsu city, Japan.
authors.forename: Mitsushige
authors.initials: M
authors.lastname: Shibatoge
authors.affiliation: Department of Gastroenterological Surgery, Takamatsu Red Cross Hospital, 4-1-3 Banchou, Takamatsu city, Kagawa prefecture, 760-0017, Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Hirose
keywords: Double-balloon enteroscopy; Non-specific multiple ulcers of the small intestine; Small intestinal ulcer; True enteroliths