{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T03:11:04Z","timestamp":1783653064303,"version":"3.55.0"},"reference-count":27,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,3,15]],"date-time":"2023-03-15T00:00:00Z","timestamp":1678838400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>A 71-year-old woman with rheumatoid arthritis who had been taking NSAIDs for many years consulted our hospital for abdominal pain. She was diagnosed with a small bowel obstruction due to an enterolith according to an abdominal CT scan that showed dilation from the enterolith in the small intestine on the oral side. It was considered that the intestinal stone was formed due to stagnation of intestinal contents and had gradually increased in size, resulting in an intestinal obstruction. We performed antegrade double-balloon endoscopy (DBE) to observe and remove the enterolith. We used forceps and a snare to fracture the enterolith. During this attempt, we found a seed in the center of the enterolith. Since the intestinal stone was very hard, cola dissolution therapy was administered from an ileus tube for 1 week. The following week, DBE was performed again, and it was found that the stone had further softened, making attempts at fracture easier. Finally, the enterolith was almost completely fractured. Intestinal stenosis, probably due to ulcers caused by NSAIDs, was found. Small bowel obstruction with an enterolith is rare. In this case, it was considered that the seed could not pass through the stenotic region of the small intestine and the intestinal contents had gradually built up around it. It has been suggested that DBE may be a therapeutic option in cases of an enterolith. Further, cola dissolution therapy has been shown to be useful in treating an enterolith, with the possible explanation that cola undergoes an acid\u2013base reaction with the enterolith. In summary, we report, for the first time, treatment of an enterolith with a combination of DBE and cola dissolution therapy, thereby avoiding surgery and its risks.<\/jats:p>","DOI":"10.3390\/medicina59030573","type":"journal-article","created":{"date-parts":[[2023,3,15]],"date-time":"2023-03-15T05:53:44Z","timestamp":1678859624000},"page":"573","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Enterolith Treated with a Combination of Double-Balloon Endoscopy and Cola Dissolution Therapy"],"prefix":"10.3390","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2593-1472","authenticated-orcid":false,"given":"Kei","family":"Nomura","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3558-7123","authenticated-orcid":false,"given":"Tomoyoshi","family":"Shibuya","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masashi","family":"Omori","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rina","family":"Odakura","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kentaro","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takafumi","family":"Maruyama","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6021-2521","authenticated-orcid":false,"given":"Mayuko","family":"Haraikawa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiichi","family":"Haga","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osamu","family":"Nomura","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirofumi","family":"Fukushima","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7419-589X","authenticated-orcid":false,"given":"Takashi","family":"Murakami","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1130-2210","authenticated-orcid":false,"given":"Dai","family":"Ishikawa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9671-5585","authenticated-orcid":false,"given":"Mariko","family":"Hojo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5979-4384","authenticated-orcid":false,"given":"Akihito","family":"Nagahara","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"17819","DOI":"10.3748\/wjg.v20.i47.17819","article-title":"Enterolithiasis","volume":"20","author":"Gurvits","year":"2014","journal-title":"World J. Gastroenterol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"E126","DOI":"10.1002\/ibd.21803","article-title":"Enterolith and small bowel perforation in Crohn\u2019s disease","volume":"17","author":"Muthukumarasamy","year":"2011","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1007\/s10140-013-1107-y","article-title":"Small-bowel obstruction associated with Crohn\u2019s enterolith","volume":"20","author":"Tewari","year":"2013","journal-title":"Emerg. Radiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1186\/s40792-021-01182-y","article-title":"Nontraumatic perforation of the small intestine caused by true primary enteroliths associated with radiation enteritis: A case report","volume":"7","author":"Hirakawa","year":"2021","journal-title":"Surg. Case Rep."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"3214","DOI":"10.1007\/s10620-006-9097-1","article-title":"Enterolith formation in the roux limb hepaticojejunostomy","volume":"52","author":"Tan","year":"2007","journal-title":"Dig. Dis. Sci."},{"key":"ref_6","first-page":"29","article-title":"Calcific enterolithiasis","volume":"5","author":"Gupta","year":"1986","journal-title":"Indian J. Gastroenterol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e227","DOI":"10.1308\/003588412X13373405385890","article-title":"Multiple large enteroliths associated with an incisional hearnia: A rare case","volume":"94","author":"Wilson","year":"2012","journal-title":"Ann. R. Coll. Surg. Engl."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1148\/radiographics.13.4.8356285","article-title":"General case of the day. Enterolith in a blind pouch (blind pouch syndrome secondary to side-to-side enteroanastomosis)","volume":"13","author":"Gin","year":"1993","journal-title":"Radiographics"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1001\/archsurg.1967.01330180046008","article-title":"Enterolithiasis associated with side-to-side intestinal anastomosis","volume":"95","author":"Kia","year":"1967","journal-title":"Arch. Surg."},{"key":"ref_10","first-page":"432","article-title":"Laminated radiopaque enteroliths: Diagnostic clues to intestinal pathology","volume":"82","author":"Paige","year":"1987","journal-title":"Am. J. Gastroenterol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1111\/j.1572-0241.2001.03497.x","article-title":"Enterolith-induced perforation in small bowel carcinoid tumor","volume":"96","author":"Khan","year":"2001","journal-title":"Am. J. Gastroenterol."},{"key":"ref_12","first-page":"331","article-title":"Small-bowel carcinoid presenting in association with a phytobezoar","volume":"34","author":"Lorimer","year":"1991","journal-title":"Can. J. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1259\/0007-1285-53-628-365","article-title":"Unusual demonstration of a Meckel\u2019s diverticulum containing enteroliths","volume":"53","author":"Athey","year":"1980","journal-title":"Br. J. Radiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1111\/j.1443-1661.2010.00981.x","article-title":"Endoscopic removal of an enterolith causing afferent loop syndrome using electrolithotripsy","volume":"22","author":"Kim","year":"2010","journal-title":"Dig. Endosc."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2439","DOI":"10.2169\/internalmedicine.54.5208","article-title":"True primary enterolith treated by balloon-assisted enteroscopy","volume":"54","author":"Ishioka","year":"2015","journal-title":"Intern. Med."},{"key":"ref_16","first-page":"002266","article-title":"Strategy for removing an impacted enterolith using double-balloon enteroscopy in crohn\u2019s disease","volume":"8","author":"Kikuchi","year":"2021","journal-title":"Eur. J. Case Rep. Intern. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2473","DOI":"10.2169\/internalmedicine.2745-19","article-title":"Cola dissolution therapy via ileus tube was effective for ileus secondary to small bowel obstruction induced by an enterolith","volume":"58","author":"Komaki","year":"2019","journal-title":"Intern. Med."},{"key":"ref_18","first-page":"517","article-title":"A case of obstructive colitis treated with Cola dissolution therapy administered via a transanal ileus tube","volume":"32","author":"Oshiro","year":"2021","journal-title":"JJAAM"},{"key":"ref_19","first-page":"e8427","article-title":"Jejunal enterolith: A rare case of small bowel obstruction","volume":"12","author":"Muacevic","year":"2020","journal-title":"Cureus"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1016\/S0016-5107(95)70022-6","article-title":"Enteroliths and Crohn\u2019s disease stricture treated by transendoscopic balloon dilation","volume":"42","author":"Gay","year":"1995","journal-title":"Gastrointest. Endosc."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1080\/00015458.2009.11680473","article-title":"Meckel\u2019s diverticulum enterolith: A rare cause of acute abdomen","volume":"109","author":"Agaoglu","year":"2009","journal-title":"Acta Chir. Belg."},{"key":"ref_22","first-page":"627","article-title":"Successful removal of massive intragastric gallstones by endoscopic electrohydraulic lithotripsy and mechanical lithotripsy","volume":"86","author":"Moriai","year":"1991","journal-title":"Am. J. Gastroenterol."},{"key":"ref_23","first-page":"457","article-title":"Endoscopic management of afferent loop syndrome caused by enteroliths and anastomotic stricture. A case report","volume":"109","author":"Alves","year":"2017","journal-title":"Rev. Esp. Enferm. Dig."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.4103\/0366-6999.232802","article-title":"Effect of double-balloon enteroscopy on diagnosis and treatment of small-bowel disease","volume":"131","author":"Tang","year":"2018","journal-title":"Chin. Med. J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"29","DOI":"10.2739\/kurumemedj.55.29","article-title":"The oldest patient with gall stone ileus: Report of a case and review of 176 cases in Japan","volume":"55","author":"Nakao","year":"2008","journal-title":"Kurume Med. J."},{"key":"ref_26","first-page":"59","article-title":"A case report of incarcerated enteroliths treated successfully by double balloon dilation using a two-channel endoscope","volume":"62","author":"Yu","year":"2020","journal-title":"Gastroenterol. Endosc."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1097\/00042737-200207000-00017","article-title":"Gastric phytobezoars may be treated by nasogastric Coca-Cola lavage","volume":"14","author":"Ladas","year":"2002","journal-title":"Eur. J. Gastroenterol. Hepatol."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/3\/573\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:55:26Z","timestamp":1760122526000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/3\/573"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,15]]},"references-count":27,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,3]]}},"alternative-id":["medicina59030573"],"URL":"https:\/\/doi.org\/10.3390\/medicina59030573","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,15]]}}}