{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T06:10:04Z","timestamp":1756361404188,"version":"3.44.0"},"reference-count":26,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,10,17]]},"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:p>We describe the case of a 73-year-old woman with a high body mass index and a virgin abdomen who presented with a 5-day history of abdominal pain, emesis and confusion on admission. Inflammatory markers and renal function were significantly deranged. CT of the abdomen and pelvis demonstrated a clear transition point and faecalisation of the small bowel proximal to the obstruction. It was suggested that the patient may have ingested a foreign object. A collateral history was obtained, making this less likely and confirmed an acute cognitive impairment. She was optimised following multidisciplinary discussion preoperatively. Thereafter, the patient underwent a laparotomy, where a hard, mobile mass was identified in the jejunum. This was diagnosed as an enterolith of dimensions 62\u00d738\u00d732 mm secondary to a duodenal diverticulum. She improved postoperatively with complete resolution of her confusion and renal function. She was discharged on day 14 of admission.<\/jats:p>","DOI":"10.1136\/bcr-2021-245159","type":"journal-article","created":{"date-parts":[[2021,11,16]],"date-time":"2021-11-16T11:50:31Z","timestamp":1637063431000},"page":"e245159","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Largest sized enterolith ileus due to a duodenal diverticulum in a virgin abdomen causing small bowel obstruction"],"prefix":"10.1136","volume":"14","author":[{"given":"Sarah Jane","family":"Afify","sequence":"first","affiliation":[{"name":"Intensive Care Medicine, Chelsea and Westminster Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8899-6620","authenticated-orcid":false,"given":"Jayan","family":"George","sequence":"additional","affiliation":[{"name":"Oncology and Metabolism, Faculty of Medicine, Dentistry and Health, The University of Sheffield, Sheffield, 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