Gallstone ileus of the sigmoid colon: a case report

Abstract

Gallstone ileus is a rare form of mechanical bowel obstruction with a biliary calculus due to complicated biliary lithiasis. The most common obstructed segment is small bowel. Colonic gallstone ileus is much rarer. Older patients with comorbidities are affected more frequently, and also women more often than men. Older age and comorbidities increase the mortality rate, additionally if the diagnosis and treatment are delayed. Since gallstone ileus is curable, it is necessary to confirm it with an abdominal CT scan or plain abdominal X-ray. Therapeutic procedures include laparotomy or laparoscopy with cololithotomy and endoscopic lithotripsy. We present a case of a 63-year-old woman who came to the emergency department with colicky abdominal pain and elevated serum inflammatory markers. Obstruction of the sigmoid colon with 4.8 cm calculus is detected with the abdominal CT scan, and it was successfully treated with laparotomy and cololithotomy.

Keywords

• gallstones – complications
• diagnostic imaging
• surgery; ileus – diagnostic imaging
• etiology
• surgery; intestinal obstruction – diagnostic imaging
• surgery; sigmoid diseases – diagnostic imaging
• surgery; laparotomy; tomography