A Rare Cause of Bowel Obstruction in a 100-year-old Patient: Gallstone Ileus

Abstract

Gallstone ileus occurs when a gallstone passes into the intestinal system through a fistula between the gallbladder or biliary tract, and the duodenum, stomach or colon, and causes an obstruction. Although it is usually seen in advanced ages, it has rarely been reported in patients who are 100 years old. A 100-year-old female patient, without significant medical or surgical history, was admitted to the emergency department for diffuse abdominal pain, nausea, vomiting, and constipation. Abdominal computed tomography showed air in the biliary tract and obstruction in the small intestine. Patient was operated under emergency conditions. Enterolithotomy was performed and the stone was extracted. Postoperative recovery was uneventful. Bilioenteric fistulas, a major complication of chronic gallbladder diseases, usually develop secondary to intense inflammation. Patients’ age, concomitant disease, clinical condition and intraoperative findings should be taken into consideration while planning the treatment. The data in the literature generally supports the employment of enterolithotomy in high-risk patients and reserves cholecystectomy and resection of the fistula for less comorbid patients with feasible anatomy.

Keywords

• cholecystoduodenal fistula
• enterolithotomy
• gallstone