ENTEROLITHIASIS WITH TUBERCULAR INTESTINAL STRICTURES.

Abstract

True enteroliths are seen very infrequently in man but occur commonly in the intestinal tract of horses and in the human appendix (Wangensteen, 1955). Hellström (1929) reported six cases of enterolithiasis, three of these were associated with multiple tubercular strictures of the ileum. Kelly (1932), Blix (1935) and Richards (1951) have described similar association of strictures and enteroliths. Foweather (1955) reported three cases of enterolithiasis, two of these were radiolucent choleic acid calculi in diverticula and one was associated with multiple, non-tubercular strictures. Atwell and Pollock, in 1960, made an extensive review of the literature and reported eight cases of true enterolithiasis. Only four of these had opaque enteroliths associated with non-tubercular lesions causing mechanical obstruction. The largest number of enteroliths reported in any one case is by Winterstein (1925) who reported 1,400 enteroliths proximal to a stricture formed post-operatively in a patient with carcinoma of the colon. Two cases are presented here, both in young Indian women. Multiple opaque enteroliths were seen on plain skiagrams which on further radiological study were found to be in the lumen of the bowel, associated with tubercular intestinal strictures. S, 24 years, female, was admitted to the Lady Hardinge Medical College and Hospital, New Delhi, on 18.7.61, for attacks of pain in the abdomen and distension off and on for the last 11 years. Pain was aggravated by food and relieved by vomiting. She also complained of loss of weight and fever associated with alternating diarrhoea and constipation.