[Intermittent small bowel obstruction secondary to enterolithiasis in Crohn's disease].

Man of 43 years-old, with no toxic habits, cardiovascular risk factors or previous surgery. He was diagnosed of Crohn's disease 11 years ago localized in ileum and colon, in treatment with mesalazine. Among the tests that were performed along the course of his disease there were two intestinal transits with barium and two colonoscopies. He came to the Emergency Unit for epigastric pain of one month of evolution, becoming continuous and more intense in the last 48 hours, accompanied of abdominal distension, nausea, vomits and constipation. To the physical examination he showed a good general condition, no fever and hemodinamic stability, with a distended abdomen, tympanic, painful to the diffuse palpation and decrease in intestinal persistalsis. Among the complementaries studies there were a hemogram and a general analysis with acute phase reactants that were within normal. In abdominal Rx we saw two rounds images with calcium density level L2-L3 on both sides of the median line. The diagnosis was completed with abdominal CT scan that reported foreign bodies in the transverse colon (Fig. 1). A colonoscopy was performed, that it could not move beyond 100 cm by insuperable stenosis at this level despite we tried dilation. The resolution of the case was not possible by endoscopy. We decided surgery by laparotomy with resection of the stenosis and removal of the stones. The histological examination reported of limestone formations, the first of 17-mm diameter and 15 mm the second (Fig. 2).