Gallstone obstruction of the second portion of the duodenum (original) (raw)
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Japanese Journal of Gastroenterology Research
Gallstone ileus is a rare cause of gastrointestinal (GI) complication of gallstone that causes mechanical intestinal obstruction due to gallstone impaction in the gastrointestinal tract. About less than 1% of intestinal obstruction is caused by this. Patients may present with non-specific signs and symptoms. Surgical relief of gastrointestinal obstruction remains the mainstay of operative treatment. Classical findings on plain abdominal radiography include (1) pneumobilia; (2) intestinal obstruction; (3) an aberrantly located gallstone; and (4) change of location of a previously observed stone. The current surgical procedures are: (1) simple enterolithotomy; (2) enterolithotomy, cholecystectomy, and fistula closure (one-stage procedure); and (3) enterolithotomy with cholecystectomy performed later (two-stage procedure). We describe a case of gallstone ileus.
Management of gallstone ileus with stone impacted in the ascending part of duodenum
Acta clinica Croatica
Gallstone ileus with impaction of gallstone in distal duodenum is an extremely rare complication of cholecystolithiasis. Gallstone ileus in itself accounts for less than 1% of these complications with 800 cases described so far. However, there are less than 15 cases described with the impaction of gallstone in distal duodenum. We report a case of an 84-year-old male patient in whom gallstone impacted in distal duodenum was found by ultrasonography and confirmed by computed tomography. Cholecystitis and a remaining large gallstone in the gallbladder were found intraoperatively, which made us opt for one-step procedure, i.e. lithotomy and fistula repair with cholecystectomy. Due to the rare position of impacted gallstone, we believe that cases like this should be reported in detail in order to generate enough data for establishing optimal treatment options.
Gall stone ileus: Unfamiliar cause of bowel obstruction. Case report and literature review
International journal of surgery case reports, 2018
Gallstone ileus is a rare sequela of cholelithiasis. The pathology occurs as a result of bilioenteric fistula due to erosion by the offending gallbladder stone. It is most commonly encountered in elderly females and CT imaging is diagnostic in the majority of cases. Surgical intervention aims to promptly relief the obstruction by removing the gallstone and dealing with the fistula. Morbidity and mortality are usually high since it usually occurs in elderly patients. An 88-year-old lady with multiple chronic medical problems and no history of biliary manifestation presented with acute small bowel obstruction. Abdominal CT imaging revealed a bilioenteric fistula and an impacted gallstone in the jejunum causing occlusion. Laparotomy was performed and the stone was removed via enterolithotomy. Manipulation of the cholecystoduodenal fistula was not attempted due to severe inflammatory adhesions. The patient had uneventiful postoperative course and remained symptom free on one year follow...
A Rare Case of Large Impacted Stone in Jejunum Causing Obstruction in a Patient of Gallstone Ileus
Galician Medical Journal
Gallstone ileus is a rare complication of cholelithiasis that occurs as a result of occlusion of the intestinal lumen by a large sized gallstone accounting for 1-4% cases of small bowel obstruction. The aim of this work is to introduce a case report that emphasize the diagnostic and therapeutic management of gallstone ileus with an enterolith impacted in jejunum (an uncommon site).
Gallstoneileus: A Rare Cause of Smallbowel Obstruction
SAS journal of medicine, 2023
Biliary ileus is a rare complication of gallstones secondary to a bilio-digestive fistula with passage of a macro calculus in the small intestine and which may be responsible for intestinal obstruction. Its misleading symptomatology often leads to diagnostic delay which worsens the prognosis. Computed tomography is the main imaging modality for diagnosis of gallstone ileus. We report the case of a 63-year-old patient presenting vomiting with diffuse abdominal pain and inability to pass gas or stool evolving for 3 days. Abdominal computed tomography revealed moderate aerobilia, an atrophic gallbladder with air bubbles associated with small bowel obstruction due to a jejunal calculus. Laparotomy revealed the presence of a cholecystoduodenal fistula, a sclero-atrophic gallbladder with the presence of a stone obstructing the lumen in the jejunum; an enterolithotomy was performed with a cholecystectomy and closure of the fistula path in a single operative step; the postoperative outcome werefavorable.
Gallstone ileus resulting in strong intestinal obstruction
Sao Paulo Medical Journal, 1995
Mechanic intestinal obstruction, caused by the passage of biliary calculus from vesicle to intestine, through fistulization, although not frequent, deserve study due to the morbi-mortality rates. Incidence in elder people explains the association with chronic degenerative diseases, increasing complexity in terms of therapy decision. Literature discusses the need and opportunity for the one or two-phase surgical attack of the cholecystenteric fistule, in front of the resolution on the obstructive urgency and makes reference to Gallstone Ileus as an exception for strong intestinal obstruction. The more frequent intestinal obstruction observed is when it occurs a Gallstone Ileus impacting in terms of ileocecal valve. The authors submit a Gallstone Ileus manifestation as causing strong intestinal obstruction, discussing aspects regarding diagnostic and treatment.
Uncommon Complication of Cholelithiasis: Gall Stone Ileus
Journal of Case Reports, 2016
Gallstone ileus is a rare complication that occurs when gall stone passes into small bowel forming a fistula between gall bladder and duodenum and gets impacted. It is associated with high morbidity and mortality and is usually responsible for about 1%-4% of cases of mechanical intestinal obstruction. The diagnosis can be confirmed by plain X-ray, ultrasound and CT scan demonstrating Rigler's triad. Surgical treatment involves removal of the impacted stone with immediate or delayed dealing with the fistula.