Department of Surgery, School of Medicine, Showa University
Ultrasonography, Enterolith, Ileus
Two patients with small-bowel obstruction due to enterolith were examined by ultrasound and a crescent-shaped strong echo with acoustic shadow in the fluid-filled small intestine was demonstrated. In the first patient, the plane radiograph of the abdomen demonstrated air-fluid levels in the small bowel, without any radiopaque substance. However after gastrointestinal series with Gastrographine, a calculus was demonstrated in the right lower quadrant. In the second patient, gastrointestinal series and endoscopic examination revealed a large bezoar. The patient was referred to our hospital due to subileus and plain radiographic study of the abdomen revealed a large radiopaque substance in the left pelvis and the extremely enlarged small intestine. Operation was performed and enterolith was taken out from the small bowel. Fortunately, enterolith was demonstrated by the radiographic examinations in these patients. However, it was not always radiopaque. Therefore, ultrasonic demonstration of the calculus in the fluid-filled small intestine can afford valuable information in diagnosis of enterolith.