Gallstone ileus - the double challenge: case report and review of the literature

Journal of Clinical and Investigative Surgery. 2016;1(1):15-21 DOI 10.25083/2559.5555.11.1521

 

Journal Homepage

Journal Title: Journal of Clinical and Investigative Surgery

ISSN: 2559-5555 (Online)

Publisher: Digital ProScholar Media

Society/Institution: Digital ProScolar media

LCC Subject Category: Medicine

Country of publisher: Romania

Language of fulltext: English

Full-text formats available: PDF

 

AUTHORS

Petrişor Banu (Carol Davila University, Department of General Surgery, Bucharest, Romania)
Vlad D. Constantin (Carol Davila University, Department of General Surgery, Bucharest, Romania)
Florian Popa (Carol Davila University, Department of General Surgery, Bucharest, Romania)
Mihaela F. Nistor (St. Pantelimon Hospital, Department of General Surgery, Bucharest, Romania)
Ion G. Motofei (Carol Davila University, Department of General Surgery, Bucharest, Romania)
Cristian Bălălău (Carol Davila University, Department of General Surgery, Bucharest, Romania)

EDITORIAL INFORMATION

Double blind peer review

Editorial Board

Instructions for authors

Time From Submission to Publication: 12 weeks

 

Abstract | Full Text

Gallstone ileus is a rare condition which occurs as an evolutive complication of biliary lithiasis. It occurs after stone migration from extrahepatic biliary tree to the digestive lumen, mostly through a biliary-enteric fistula. This condition involves repeated inflammatory relapses with the formation of local adhesions and generally requires a long evolution. The vast majority of patients with biliary ileus are third aged women who often have concomitant medical illnesses. Gallstone ileus surgery deals with the two components: bowel obstruction and biliary pole. Obstruction solving is approached as a surgical emergency and it requires an attitude adapted to the local situation. The attitude towards biliary surgery for gallstone ileus is a matter in debate. It could be one-stage surgery, elective surgery or expectancy and its choice is imposed by both local and general condition of the patient. We report the case of a middle-age woman whose first symptom of cholelithiasis was the gallstone ileus. Plain upright abdominal radiography revealed air-fluid levels with distended loops of the small bowel and pneumobilia. Laparotomy was decided and exploration revealed an impacted gallstone into the ileum and dense adhesions were found under the liver region. Enterolithotomy for gallstone removal was made. Postoperative evolution was uneventful with discharge on 7th day.