Small bowel obstruction and perforation secondary to primary enterolithiasis in a patient with jejunal diverticulosis.

We describe a rare case of small bowel obstruction and perforation secondary to a primary enterolith in an 84-year-old female patient with jejunal diverticulosis. She underwent an emergency laparotomy, small bowel resection and primary anastomosis. Multiple jejunal diverticula and a large stone were identified at the time of operation. Analysis of the stone demonstrated mainly faecal material consistent with a true primary enterolith. A literature search of Medline and PubMed revealed three cases similar to the one described. The pathogenesis and management of enterolithiasis in jejunal diverticular disease is considered.

Non-traumatic compartment syndrome secondary to deep vein thrombosis and anticoagulation.

We describe an unusual case of non-traumatic compartment syndrome in three compartments of the left lower limb in a 57-year-old male inpatient. He had recently been started on anticoagulation therapy for multiple pulmonary emboli and deep vein thrombosis of the left posterior tibial and peroneal veins. Three of the four osteofascial compartments had pressures above 70 mm Hg, hence four compartment fasciotomies were performed. Postoperatively, intravenous heparin therapy was started resulting in a significant blood loss, but he had no neurovascular deficit. At reoperation, for primary wound closure, his tissues looked healthy. Non-traumatic causes of acute compartment syndrome, including deep venous thrombosis and anticoagulation, are considered.