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The site of the cholecystoduodenal fistula A small bowel obstruction with no clear transition point was noted.
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Gallstone ileus is an uncommon condition that is difficult to diagnose clinically. Although several cases have been reported in the literature, radiolucent gallstones in the setting of gallstone ileus are an exceedingly rare occurrence, and we have not identified any authors who used magnetic resonance imaging (MRI) for the acute diagnosis of this...
Context in source publication
Context 1
... computed tomography (CT) scan of the abdomen reported findings suspicious for chronic cholecystitis and secondary cholecystoduodenal fistula, with mild dilatation of the common bile duct. CT also revealed prominent dilated loops of the small bowel with air-fluid levels and distal transition points concerning for small bowel obstruction (Figure 1). He was initially treated with antibiotics, a nasogastric tube, and diet restriction with a plan for magnetic resonance enterography (MRE). ...
Similar publications
The term "gallstone ileus" refers to intestinal obstruction brought on by a gallstone lodged within its lumen. The gallstone travels through a fistula that develops because of the constant pressure it exerts on the gall bladder. The symptoms are vague and confounding which can commonly lead to delay in diagnosis. The preferred imaging technique is...
Citations
... Moreover, while gallstone ileus has been described in the literature, no reports of MRI in the acute setting being used for diagnostic purposes have been reported. Therefore, if there is a high index of suspicion for gallstone ileus, gallstone ileus warrants expedited MRI to confirm the diagnosis due to the urgency of management [8]. ...
Intestinal obstruction caused by enteroliths is an uncommon medical condition. Timely detection of the presence of enteroliths and identification of their origin can guide clinical treatment. This study aimed to present the Computed Tomography (CT) features of enterolithic ileus confirmed by surgery in 7 patients. Seven patients with surgically confirmed enterolithic ileus who were admitted to our hospital between December 2013 and December 2022 were continuously enrolled, and an abdominopelvic CT examination was performed before surgery. The imaging characteristics were then analyzed. In the transition zone of all patients with intestinal obstruction, the sharply defined intraluminal masses were found. Three of them had gallstones and 4 had primary enteroliths. All 5 enteroliths in the 4 patients with primary enteroliths were in the proximal small intestine and were low-density with gas. Additionally, 3 gallstones were present in the distal small bowel, and calcifications were observed. Simultaneously, cholecystitis and secondary cholecystoduodenal fistula were observed in all 3 patients with gallstones. Compared to gallstones, primary enteroliths tend to be higher positioned, less dense, and accompanied by gas. CT examination is very important, as it allows accurate identification, location, diagnosis, and identification of complications of the different types of enteroliths to provide a basis for surgery.
