MECKELS ENTEROLITHS - CLINICAL, RADIOLOGIC, AND PATHOLOGICAL FINDINGS

OBJECTIVE. The objective of this study was to determine the clinical, radiographic, and pathologic findings of Meckel's enteroliths, a rare complication of Meckel's diverticulum. MATERIALS AND METHODS. Of 84 ca ses of Meckel's diverticulum, eight (10%) were found at surgery to con tain enteroliths. Abdominal radiographs and barium studies of these ei ght patients were reviewed retrospectively. Medical and pathologic rec ords were also reviewed. RESULTS. At the time of diagnosis, the median age of the eight patients with Meckel's enteroliths was 45 years old. Six patients were male, and two were female. All eight patients were symptomatic, but symptoms were chronic in six patients (75%). Meckel's enteroliths were seen on abdominal radiographs in seven patients (88% ). The stones had an average diameter of 3 cm (range, 1-5 cm). Five pa tients had multiple opaque stones, and two patients had solitary stone s (total number of stones, 18). Sixteen of the enteroliths were reveal ed as peripheral calcified stones with radiolucent centers; two were r evealed as laminated stones. One patient had a Meckel's stone ileus du e to extrusion of an enterolith into the lumen that subsequently cause d small-bower obstruction. Histologically, all Meckel's diverticula wi th enteroliths contained intestinal mucosa lining without ectopic gast ric mucosa. CONCLUSION. Meckel's enteroliths are a rare complication o f Meckel's diverticulum. Nevertheless, this entity should be included in the differential diagnosis of abdominal calcification when a periph eral calcified stone or, less commonly, a laminated stone is detected in the lower abdomen on radiographs of adults with chronic abdominal p ain or gastrointestinal blood loss.