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Ileostomy obstruction by ingested apricot stone with clinical-radiological-pathological correlation
A J George1, R C Fallaize1, J Bennett1
1Bristol Royal Infirmary, Bristol, Avon, UK.
BMJ Case Reports
|September 17, 2015
Summary
A 62-year-old woman with an ileostomy experienced bowel obstruction due to an ingested apricot stone. Endoscopic removal failed, leading to stoma revision and successful resolution of the obstruction.
Area of Science:
- Gastroenterology
- Surgical Case Reports
Background:
- Bowel obstruction is a common complication in patients with stomas, frequently caused by adhesions.
- End ileostomies are surgical diversions of the ileum, often necessary after bowel resection.
Observation:
- A 62-year-old woman with an end ileostomy presented with acute abdominal pain and subacute bowel obstruction.
- Multimodality imaging identified an ingested apricot stone causing luminal obstruction in the distal ileum, proximal to the stoma.
Findings:
- Initial conservative management and attempted digital extraction under anesthesia were unsuccessful.
- Endoscopic removal of the apricot stone provided temporary relief, but the patient relapsed within 48 hours.
- Subsequent stoma revision surgery resolved the small bowel obstruction without further complications.
Implications:
- This case highlights the importance of considering foreign body ingestion in stoma obstruction.
- Endoscopic management may be attempted but is not always successful for large intraluminal foreign bodies.
- Stoma revision remains a definitive treatment option for persistent or recurrent stomal obstructions.
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