We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Enterolith Small Bowel Obstruction (Pseudogallstone Ileus)

Victor S. Falk, MD
Arch Surg. 1974;108(5):749. doi:10.1001/archsurg.1974.01350290111024.
Text Size: A A A
Published online


To the Editor.-A 70-year-old woman had symptoms and findings typical of small bowel obstruction. Previously she had had a hysterectomy, appendectomy, fractured cervical spine, cholecystectomy, fractured hip, and parkinsonism for 15 years. She also had had upper gastrointestinal tract and barium enema x-ray studies that were unremarkable. She had been taking 2,500 mg of levodopa daily.

A mass, described as a "huge balllike fecal impaction," could be palpated rectally and vaginally. The abdomen was distended and tympanitic. A flat plate of the abdomen showed dilated loops of small bowel measuring up to 6 cm in diameter with airfluid levels. Nasogastric suction was instituted and the returns were fecal.

At laparotomy, distended loops of small bowel and a large egg-shaped intraluminal obstruction in the distal ileum were encountered. An antimesenteric enterotomy was made, and the large calculus removed. The enterotomy was closed without resection. Postoperatively, bowel function resumed rapidly.



Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.