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Ursodeoxycholic Acid Triggers Primary Enterolith Growth in a Crohn's Disease Patient with Jejunal Stenosis

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Title: Ursodeoxycholic Acid Triggers Primary Enterolith Growth in a Crohn's Disease Patient with Jejunal Stenosis
Authors: Matsui, Hiroki Browse this author
Yoshida, Tadashi Browse this author
Homma, Shigenori Browse this author →KAKEN DB
Ichikawa, Nobuki Browse this author
Emoto, Shin Browse this author
Miyaoka, Yoichi Browse this author
Sakurai, Kensuke Browse this author
Odagiri, Shinsuke Browse this author
Katsurada, Takehiko Browse this author
Taketomi, Akinobu Browse this author →KAKEN DB
Keywords: Crohn's disease
primary enterolith
stenosis of proximal small intestine
ursodeoxycholic acid
Issue Date: 28-Oct-2021
Publisher: Japan Society of Coloproctology
Journal Title: Journal of the Anus Rectum and Colon
Volume: 5
Issue: 4
Start Page: 433
End Page: 438
Publisher DOI: 10.23922/jarc.2021-017
Abstract: Primary enteroliths associated with Crohn's disease have been considered to be rare and are most likely caused by severe ileal stenosis. Herein, we report the case of a primary enterolith possibly caused by mild jejunal stenosis in a Crohn's disease patient who received oral administration of ursodeoxycholic acid (UDCA). A 62-year-old woman with a 6-year history of Crohn's disease, currently in clinical remission, was on UDCA prescription for liver dysfunction. Magnetic resonance imaging and double-balloon endoscopy, which were performed to examine epigastric pain, revealed mild jejunal stenosis and an enterolith on the oral side. Since it was difficult to remove or crush the enterolith endoscopically, we decided to remove it surgically with the stenotic jejunum. Component analysis revealed that more than 98% of the enterolith was composed of UDCA; subsequently, oral administration of UDCA was discontinued. This case demonstrated that primary enterolith might develop in Crohn's disease patients with mild intestinal stenosis, and oral administration of UDCA can trigger an enterolith in such patients. Therefore, routine follow-up imaging is necessary for early detection. Oral UDCA should be administered with caution for Crohn's disease patients with stenosis of the proximal small intestine.
Type: article
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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