Small bowel obstruction secondary to enterolith impaction complicating jejunal diverticulitis.

Abstract

A case of small bowel obstruction secondary to enterolith impaction in the presence of jejunal diverticular disease is described. Only 27 cases of small bowel obstruction by enterolith expelled from small bowel diverticula have been reported in the literature. The reported incidence of jejunal diverticulosis in the general population ranges from 0.02 to 7.1%. Most patients are asymptomatic, but 10% develop complications requiring surgical intervention. Surgical treatment is an enterotomy and stone extraction or manually crushing and milking the stone distally into the colon. Small bowel resection and anastomosis or laparoscopic-assisted small bowel resection are indicated for the treatment of diverticulitis, bowel perforation, or multiple diverticuli. Jejunal diverticular disease should be considered in the differential diagnosis of mechanical small bowel obstruction without an obvious cause, especially in the elderly population.