A Case of Calcium Enterolith of the Ileum

Hirokazu Matsutomo, Akihiko Gotoh, Toyoo Nitta, Masayoshi Ichihashi, Makoto Tarao

Department of Surgery, Hashima City Hospital

Enteroliths are infrequently encountered. We report here a case of a surgically treated enterolith with perforation and ileus. A 68-year-old woman presented with lower abdominal pain. Physical examination at admission showed tenderness with Blumberg sign of her lower abdomen and a painful mass was palpated in the right lower quadrant. Plain abdominal X-ray film showed abnormal intestinal gas and calcified stone shadows in the pelvic cavity. Pelvic computed tomography revealed calcified stone shadows in the bowel. Blood laboratory studies showed 15,600 leucocytes per mm³ and 14.8 mg of CRP per dl. An emergency operation was carried out. During laparotomy, segmental stenosis and a pin-hole perforation in the ileum 40 cm orad from ileocecal portion were detected, and intestinal stones were palpated in the lumen. Part of the ileum was resected and a calcium enterolith was diagnosed by chemical analysis by infrared rays. In the present case, stenosis of the ileum due to adhesion after appendectomy was considered to have caused stagnation of the intestinal contents, which led to formation of the enterolith.

Key words
enterolith, calcium enterolith, acute abdomen

Reprint requests
Hirokazu Matsutomo Department of Surgery, Hashima City Hospital
3-246 Shinsei-cho, Hashima-city, 501-62 JAPAN

Accepted
October 1, 1997

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