Small Bowel Obstruction Secondary to an Expelled Enterolith From Jejunal Diverticulum: A Rare Entity

We describe a rare case of a mechanical small bowel obstruction secondary to multiple enteroliths expelled from underlying jejunal diverticular disease. A 59-year-old male, without any past surgical history presented to a regional hospital in Queensland with symptoms consistent with an acute small bowel obstruction. A CT scan performed on arrival confirmed the diagnosis of a small bowel obstruction with a transition point at the level of mid small bowel however the aetiology was not radiologically apparent. He proceeded to an exploratory laparotomy which revealed at least three intraluminal enteroliths, one of which was impacted within the mid jejunum resulting in the bowel obstruction. These enteroliths were all milked distally and successfully retrieved via an enterotomy in a healthy segment of distal ileum. He was also noted intraoperatively to have extensive proximal jejunal diverticular disease as the likely source of his dislodged enteroliths. Retrospectively, his CT scan could be correlated to his intraoperative findings, bringing to light this rare phenomenon which has been documented only in a handful of published cases within surgical and gastroenterology literature.