ENTEROLITHIASIS, REFRACTORY-ANEMIA, AND STRICTURES OF CROHNS-DISEASE

In Crohn's disease, multiple areas of small bowel stenosis are relativ ely common, but there are only 11 reported cases with stenosis complic ated by enterolithiasis. We describe three patients with multiple stri ctures, enterolithiasis, and refractory iron deficiency anemia. The ch ronic anemia was severe, requiring multiple transfusions in two patien ts. One patient developed a perforation, and a second had cancer withi n one of the saccular dilatations between strictures. Management of th is stricture-enterolith-anemia triad requires removal of the enterolit hs and correction of the strictures by strictureplasty and/or resectio n. If the operation of choice is strictureplasty, however, meticulous inspection and biopsy of each proposed site of enteroplasty is essenti al to rule out carcinoma.