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Enterolith Treated with a Combination of Double-Balloon Endoscopy and Cola Dissolution Therapy
A 71-year-old woman with rheumatoid arthritis who had been taking NSAIDs for many years consulted our hospital for abdominal pain. She was diagnosed with a small bowel obstruction due to an enterolith according to an abdominal CT scan that showed dilation from the enterolith in the small intestine o...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10051240/ https://www.ncbi.nlm.nih.gov/pubmed/36984574 http://dx.doi.org/10.3390/medicina59030573 |
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author | Nomura, Kei Shibuya, Tomoyoshi Omori, Masashi Odakura, Rina Ito, Kentaro Maruyama, Takafumi Haraikawa, Mayuko Haga, Keiichi Nomura, Osamu Fukushima, Hirofumi Murakami, Takashi Ishikawa, Dai Hojo, Mariko Nagahara, Akihito |
author_facet | Nomura, Kei Shibuya, Tomoyoshi Omori, Masashi Odakura, Rina Ito, Kentaro Maruyama, Takafumi Haraikawa, Mayuko Haga, Keiichi Nomura, Osamu Fukushima, Hirofumi Murakami, Takashi Ishikawa, Dai Hojo, Mariko Nagahara, Akihito |
author_sort | Nomura, Kei |
collection | PubMed |
description | A 71-year-old woman with rheumatoid arthritis who had been taking NSAIDs for many years consulted our hospital for abdominal pain. She was diagnosed with a small bowel obstruction due to an enterolith according to an abdominal CT scan that showed dilation from the enterolith in the small intestine on the oral side. It was considered that the intestinal stone was formed due to stagnation of intestinal contents and had gradually increased in size, resulting in an intestinal obstruction. We performed antegrade double-balloon endoscopy (DBE) to observe and remove the enterolith. We used forceps and a snare to fracture the enterolith. During this attempt, we found a seed in the center of the enterolith. Since the intestinal stone was very hard, cola dissolution therapy was administered from an ileus tube for 1 week. The following week, DBE was performed again, and it was found that the stone had further softened, making attempts at fracture easier. Finally, the enterolith was almost completely fractured. Intestinal stenosis, probably due to ulcers caused by NSAIDs, was found. Small bowel obstruction with an enterolith is rare. In this case, it was considered that the seed could not pass through the stenotic region of the small intestine and the intestinal contents had gradually built up around it. It has been suggested that DBE may be a therapeutic option in cases of an enterolith. Further, cola dissolution therapy has been shown to be useful in treating an enterolith, with the possible explanation that cola undergoes an acid–base reaction with the enterolith. In summary, we report, for the first time, treatment of an enterolith with a combination of DBE and cola dissolution therapy, thereby avoiding surgery and its risks. |
format | Online Article Text |
id | pubmed-10051240 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-100512402023-03-30 Enterolith Treated with a Combination of Double-Balloon Endoscopy and Cola Dissolution Therapy Nomura, Kei Shibuya, Tomoyoshi Omori, Masashi Odakura, Rina Ito, Kentaro Maruyama, Takafumi Haraikawa, Mayuko Haga, Keiichi Nomura, Osamu Fukushima, Hirofumi Murakami, Takashi Ishikawa, Dai Hojo, Mariko Nagahara, Akihito Medicina (Kaunas) Case Report A 71-year-old woman with rheumatoid arthritis who had been taking NSAIDs for many years consulted our hospital for abdominal pain. She was diagnosed with a small bowel obstruction due to an enterolith according to an abdominal CT scan that showed dilation from the enterolith in the small intestine on the oral side. It was considered that the intestinal stone was formed due to stagnation of intestinal contents and had gradually increased in size, resulting in an intestinal obstruction. We performed antegrade double-balloon endoscopy (DBE) to observe and remove the enterolith. We used forceps and a snare to fracture the enterolith. During this attempt, we found a seed in the center of the enterolith. Since the intestinal stone was very hard, cola dissolution therapy was administered from an ileus tube for 1 week. The following week, DBE was performed again, and it was found that the stone had further softened, making attempts at fracture easier. Finally, the enterolith was almost completely fractured. Intestinal stenosis, probably due to ulcers caused by NSAIDs, was found. Small bowel obstruction with an enterolith is rare. In this case, it was considered that the seed could not pass through the stenotic region of the small intestine and the intestinal contents had gradually built up around it. It has been suggested that DBE may be a therapeutic option in cases of an enterolith. Further, cola dissolution therapy has been shown to be useful in treating an enterolith, with the possible explanation that cola undergoes an acid–base reaction with the enterolith. In summary, we report, for the first time, treatment of an enterolith with a combination of DBE and cola dissolution therapy, thereby avoiding surgery and its risks. MDPI 2023-03-15 /pmc/articles/PMC10051240/ /pubmed/36984574 http://dx.doi.org/10.3390/medicina59030573 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Case Report Nomura, Kei Shibuya, Tomoyoshi Omori, Masashi Odakura, Rina Ito, Kentaro Maruyama, Takafumi Haraikawa, Mayuko Haga, Keiichi Nomura, Osamu Fukushima, Hirofumi Murakami, Takashi Ishikawa, Dai Hojo, Mariko Nagahara, Akihito Enterolith Treated with a Combination of Double-Balloon Endoscopy and Cola Dissolution Therapy |
title | Enterolith Treated with a Combination of Double-Balloon Endoscopy and Cola Dissolution Therapy |
title_full | Enterolith Treated with a Combination of Double-Balloon Endoscopy and Cola Dissolution Therapy |
title_fullStr | Enterolith Treated with a Combination of Double-Balloon Endoscopy and Cola Dissolution Therapy |
title_full_unstemmed | Enterolith Treated with a Combination of Double-Balloon Endoscopy and Cola Dissolution Therapy |
title_short | Enterolith Treated with a Combination of Double-Balloon Endoscopy and Cola Dissolution Therapy |
title_sort | enterolith treated with a combination of double-balloon endoscopy and cola dissolution therapy |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10051240/ https://www.ncbi.nlm.nih.gov/pubmed/36984574 http://dx.doi.org/10.3390/medicina59030573 |
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