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Gallstone ileus is an infrequent complication of cholelithiasis. The formation of a fistula between the gallbladder and the duodenum may allow a gallstone to enter the intestinal tract. Gallstone ileus usually occurs in the elderly with a female predominance and is associated with a high mortality rate. The diagnosis is difficult; early diagnosis c...
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... patient was referred for nonspiral, noncontrast, abdominal computed tomography (CT). Axial images showed discontinuity of the duodenal wall at the area neighboring the gallbladder (Fig. 2), in addition to phlegmonous changes in the subhepatic fatty tissues and pericholecystic and periduodenal areas (Fig. 3), abnormal gas in the gallbladder fossa (Fig. 4), dilated small intestine, and a bilaminated stone, 30 mm in diameter, located just proximal to the terminal ileum (Fig. 5). These features confirmed the presence of gallstone ileus. The patient underwent primary treatment with intravenous fluids (0.9% sodium chloride) and nasogastric decompression and was transferred to an advanced ...
Citations
... There are several types of the fistula with cholecystoduodenal fistula being the most common (75%), followed by cholecystocolic fistula (10-20%) and other types (15%). [3] Its prevalence rate ranges between 1% and 4% from all bowel obstruction cases. Less than 25% of non-strangulated small-bowel obstruction in older patients (>65 years) are cause by GI. ...
BACKGROUND: Gallstone ileus (GI) is a mechanical obstruction in the intestinal lumen due to gallstones. Its prevalence is very low, but it possesses a high mortality rate. It is commonly found in older female population. CASE REPORT: We reported a case of GI in a 61-year-old Chinese female, who presented with acute onset of abdominal pain, nausea, and intermittent vomiting. On water-soluble contrast follow-through examination, she showed total bowel obstruction on the level of terminal ileum due to suspected gallstone. Exploratory laparotomy with procedure of enterolithotomy and stone removal by milking the bowel distal to the stone were performed. Post-operative course was uneventful, but the patient was discharged at post-operative day 8. Furthermore, the patient underwent cholecystectomy and fistula repair in the following days (two-stage surgery). She was followed up in the clinic for 12 months and the patient remained asymptomatic. CONCLUSION: GI is a rare medical condition with a high mortality rate, commonly affecting females and elder population. It must be considered in a patient with bowel obstruction, especially with a history of cholelithiasis. Many clinicians prefer enterolithotomy alone, followed by cholecystectomy at later date, because of its lower morbidity and report high spontaneous fistula closure.
... It is a rare complication of cholecystolithiasis, occurring as a complication in 3% of all cases. However, it causes of up to 25% of all small bowel obstructions in elderly patients (over 65 years old) [3, 4]. It is considered that the constant pressure from a large gallstone causes the formation of a bilio-digestive fistula through which the gallstone is expulsed into the bowels. ...
Gall stone ileus is a rare serious complication of cholelithiasis. We report a case of cholecystoduodenal fistula presenting as gall stone ileus with acute kidney injury which was managed successfully.
