Roux-en-Y gastric bypass (RYGB) is the second most common bariatric procedure performed worldwide (39.6%) [1]. However, despite low mortality rates [2], this procedure is not free of complications [3]. Small bowel obstruction (SBO) after RGYB has an incidence of 7.3% [4]. It is most commonly caused by adhesions (33%) and internal herniation (31%) [5]. Enterolith ileus (EI) is an uncommon cause of SBO generated by intraluminal stone formation. Primary enterolithiasis occurs in areas of stasis associated with intestinal diverticula, enteroanastomosis, afferent loops in Roux-en-Y procedures, intestinal kinking, stenosis and strictures, tumors, and hernias [6].
