Primary Small Bowel Stone (Primary Enterolith) in a Patient with Stricturing Ileal Crohn’s Disease: A Case Report

Abstract

Introduction: Intestinal stricture is a common complication of Crohn's disease, occurring in up to 50% of patients. It typically presents with manifestations of intestinal obstruction. A rare complication of such strictures is the formation of primary enteroliths (stones formed within the gastrointestinal tract), due to intestinal stasis. This aim of this report is to describe a case of a primary enterolith in a patient with stricturing ileal Crohn's disease. Case Presentation: A 35-year-old male presented with symptoms of chronic intestinal obstruction (IO). His surgical history was significant for an exploratory laparotomy with small bowel resection for IO in 2004. The clinical diagnosis of an ileal stricture with an associated enterolith was radiologically confirmed by computed tomography (CT) and later verified by pathological and chemical analysis of the surgical specimen. Following nutritional optimization, the patient underwent successful abdominal exploration which included both stricturoplasty and resection with primary anastomosis of the affected bowel segment. Conclusion: This case report presents a rare complication of a common condition, underscores the utility of CT in its diagnosis, highlights the importance of nutritional management and provides the details of surgical intervention and its outcomes.