PMC5007228_01
Erect X ray abdomen showing radiopaque shadow in the right iliac fossa
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Fig1
An X-ray abdomen in erect posture showed a radiopaque mass in the right iliac fossa with a dilated segment of small bowel, seen as a localised gas shadow on the X-ray (Fig. 1).
Barium Meal follow through showing radiopaque shadow in right iliac fossa, multiple strictures (arrows), dilated proximal intestinal segment with distal collapsed segment
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Fig2
A grossly dilated proximal ileal segment and collapsed distal segment was noted (Fig. 2).
a Multiple ileal strictures. b Dilated blind loop segments with bowel discolouration of the distal blind loop (arrow head). c Enterotomy incision with enterolith
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Fig3
Mesenteric thickening and adhesions between the small bowel were present (Fig. 3a, b). On palpation an enterolith was palpated in the distal segment (Fig. 3b). Enterolith was delivered through an enterotomy incision over the distal segment (Fig. 3c).
The resected ileo-ileal specimen with appendix and the enterolith
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Fig4
The pathological ileal segment consisting of multiple strictures was resected and an end to end ileo-ileal anastomoses was done, along with appendicectomy (Fig. 4).
Enterolith measuring 2.5 x 1.5 cm
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Fig5
The enterolith retrieved measured 2.5 x 1.5 cm (Fig. 5).
Histopathology showing eosinophilic and neutrophilic infiltrates in the ileal Mucosa and muscularis
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Fig6
The histopathology of the ileal specimen showed inflammatory cell infiltrate mainly neutrophils and eosinophils (Fig. 6).