부산대학교 도서관

A 51–year–old woman presented to our department with a history of recurrent episodes of small bowel obstruction since the age of 43 years. She had undergone intestinal bypass for congenital small bowel stenosis 2 days after her birth. Abdominal CT revealed 4 high–concentration density calcifications in the dilated and sac–like segment of the intestine on the oral aspect of the anastomotic site. We suspected intra–intestinal fistula due to Meckel’s diverticulum or multiple intestinal tracts. Intraoperative exploration revealed a dilated segment of the intestine 50 cm oral to Bauhin valve. A saccular type of dilatation was observed at the site of the previous intestinal anastomosis performed for congenital small bowel stenosis, and this dilated part of the intestine contained four enteroliths measuring a few centimeters in diameter. We suggest that the usually incarcerated enterolith dropped every now and then into the intestine on the anal side of the bypass anastomosis, causing recurrent episodes of small bowel obstruction. The postoperative course was uneventful, and the patient was discharged on the 6th postoperative day. In this case, we believe that the enteroliths that gradually formed at the site of anastomosis were responsible for the recurrent episodes of small bowel obstruction. To the best of our knowledge, there are few reports of similar situations.