Ursodeoxycholic Acid Triggers Primary Enterolith Growth in a Crohn's Disease Patient with Jejunal Stenosis.

Crohn's disease primary enterolith stenosis of proximal small intestine ursodeoxycholic acid

Journal

Journal of the anus, rectum and colon
ISSN: 2432-3853
Titre abrégé: J Anus Rectum Colon
Pays: Japan
ID NLM: 101718055

Informations de publication

Date de publication:
2021
Historique:
received: 01 03 2021
accepted: 06 05 2021
entrez: 8 11 2021
pubmed: 9 11 2021
medline: 9 11 2021
Statut: epublish

Résumé

Primary enteroliths associated with Crohn's disease have been considered to be rare and are most likely caused by severe ileal stenosis. Herein, we report the case of a primary enterolith possibly caused by mild jejunal stenosis in a Crohn's disease patient who received oral administration of ursodeoxycholic acid (UDCA). A 62-year-old woman with a 6-year history of Crohn's disease, currently in clinical remission, was on UDCA prescription for liver dysfunction. Magnetic resonance imaging and double-balloon endoscopy, which were performed to examine epigastric pain, revealed mild jejunal stenosis and an enterolith on the oral side. Since it was difficult to remove or crush the enterolith endoscopically, we decided to remove it surgically with the stenotic jejunum. Component analysis revealed that more than 98% of the enterolith was composed of UDCA; subsequently, oral administration of UDCA was discontinued. This case demonstrated that primary enterolith might develop in Crohn's disease patients with mild intestinal stenosis, and oral administration of UDCA can trigger an enterolith in such patients. Therefore, routine follow-up imaging is necessary for early detection. Oral UDCA should be administered with caution for Crohn's disease patients with stenosis of the proximal small intestine.

Identifiants

pubmed: 34746509
doi: 10.23922/jarc.2021-017
pmc: PMC8553354
doi:

Types de publication

Case Reports

Langues

eng

Pagination

433-438

Informations de copyright

Copyright © 2021 by The Japan Society of Coloproctology.

Déclaration de conflit d'intérêts

Conflicts of Interest There are no conflicts of interest.

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Auteurs

Hiroki Matsui (H)

Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, Japan.

Tadashi Yoshida (T)

Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, Japan.

Shigenori Homma (S)

Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, Japan.

Nobuki Ichikawa (N)

Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, Japan.

Shin Emoto (S)

Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, Japan.

Yoichi Miyaoka (Y)

Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, Japan.

Kensuke Sakurai (K)

Department of Gastroenterology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.

Shinsuke Odagiri (S)

Department of Gastroenterology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.

Takehiko Katsurada (T)

Department of Gastroenterology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.

Akinobu Taketomi (A)

Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, Japan.

Classifications MeSH