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Year : 2021  |  Volume : 1  |  Issue : 1  |  Page : 44

Stones and abdominal pain – Not the usual suspects


1 Department of Gastroenterology, Christian Medical College, Vellore, Tamil Nadu, India
2 Department of Radiology, Christian Medical College, Vellore, Tamil Nadu, India

Date of Submission19-Aug-2020
Date of Decision21-Aug-2020
Date of Acceptance02-Sep-2020
Date of Web Publication04-Dec-2020

Correspondence Address:
Amit Kumar Dutta
Department of Gastroenterology, Christian Medical College, Vellore - 632 004, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ghep.ghep_15_20

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How to cite this article:
Jaleel R, Desai G, Dutta AK. Stones and abdominal pain – Not the usual suspects. Gastroenterol Hepatol Endosc Pract 2021;1:44

How to cite this URL:
Jaleel R, Desai G, Dutta AK. Stones and abdominal pain – Not the usual suspects. Gastroenterol Hepatol Endosc Pract [serial online] 2021 [cited 2021 Jan 16];1:44. Available from: http://www.ghepjournal.com/text.asp?2021/1/1/44/302217



A 52-year-old woman? presented with a history of recurrent abdominal pain for the past 5 years. The pain was moderate to severe in intensity, located predominantly in the periumbilical region, and lasted for few hours. There was no history of vomiting, significant abdominal distension, or obstipation. Examination of the abdomen was unremarkable. Upper gastrointestinal endoscopy and colonoscopy with segmental mucosal biopsies were normal. Based on her symptoms and location of abdominal pain, computed tomography enterography was done. It showed focal stricture in the mid-ileal loop with proximal ileal loop dilatation. Multiple enteroliths were noted in the dilated segment of the ileum [Figure 1a and b].

Enterolithiasis is a rare condition and may be primary or secondary based on the site of origin.[1] Primary enteroliths are formed de novo in the intestine following prolonged stasis of contents in the lumen, whereas secondary enteroliths migrate to the intestine from extraintestinal locations. The stasis usually results from stricture, blind loops, or diverticula. Accordingly, enterolithiasis has been noted with small bowel strictures due to Crohn’s disease, tuberculosis, narrowed surgical anastomotic site, and small bowel diverticula.[2] Clinical features include intermittent abdominal pain suggestive of partial bowel obstruction, but they may be asymptomatic. Some patients develop complications such as intestinal obstruction, ulceration, or perforation.[1] The treatment is usually aimed at managing the underlying cause and often requires surgical intervention. Gallbladder, bile duct, kidney/ureter, and pancreas are the usual locations of stones in the abdomen associated with pain. Our patient had an unusual location of stones which formed due to prolonged stasis of small bowel contents proximal to the stricture.

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Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Gurvits GE, Lan G. Enterolithiasis. World J Gastroenterol 2014;20:17819-29.  Back to cited text no. 1
    
2.
Wroblewski RL, Sticca RP. Images in clinical medicine. Primary small-bowel enterolithiasis. N Engl J Med 2008;359:1271.  Back to cited text no. 2
    


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