637 Enterolith Ileus Secondary to Small Bowel Diverticulum: A Rare Cause of Small Bowel Obstruction

Abstract Small intestinal diverticula are rare and possibly acquired secondary to bowel dyskinesia, abnormal peristalsis, or high intraluminal pressures. Enterolith formation obstruction a less encountered complication of these diverticula. An elderly man, with no history abdominal surgery, presented 10 days colicky right iliac fossa pain recurrent episodes bilious vomiting. He initially reported diarrhoea but complained eventual absolute constipation for last 5 days. Physical examination revealed distended abdomen right-sided tenderness mass faeces on rectal examination. Abdominal CT 3.5 cm calculus in the distal ileum causing flagged as gallstone ileus. No gallstones pneumobilia were identified although some intrahepatic duct dilatation was noted. emergency laparotomy conducted, where radiological findings reinforced, extracted via enterotomy. There communications between gallbladder tract. The small traced from duodenojejunal flexure terminal did not reveal any further calculi FTIR spectrum analysis specimen indicated similarities enterolith. Retrospective images possible duodenal diverticulum. case highlights diagnostic conundrum therapeutic challenges diverticular