Small bowel diverticulum causing primary enterolithiasis: a rare diagnosis with definitive surgical intervention

Primary enterolithiasis is characterized by the formation of stones within the small bowel. The prevalence is estimated to be ~0.3% to 10% in selected populations. Due to its rarity, diagnosis is often delayed. We present the case of a 77 year old male who presented with small bowel obstruction, which was initially thought to be due to intussusception seen on abdominal computed tomography scan. He underwent two diagnostic laparoscopies within 1 month because his small bowel obstruction did not resolve with the initial surgery. The primary enterolith was not discovered until the second surgery where a 5 cm primary enterolith was seen in the small bowel causing early mucosal necrosis. The stone was removed, and the enterotomy was closed. After the enterolith was removed, the patient's upper gastrointestinal symptoms completely resolved.