scholarly journals 939 Enterovaginal Fistula; Could It Be Gallstones?

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
S Kapoor ◽  
M Boshnaq ◽  
C Wright
Keyword(s):  
Rare Complication ◽  
Gallstone Ileus ◽  
Small Bowel Resection ◽  
Pelvic Radiotherapy ◽  
Cholecystoduodenal Fistula ◽  
Rare Presentation ◽  
History Of ◽  
Enterovaginal Fistula ◽  
Resection And Anastomosis ◽  
Pelvic Ct Scan

Abstract This is a rare presentation of an impacted gallstone leading to a ileovaginal fistula. A 76-year old female presented with a 4 week history of faecal vaginal discharge and weight loss on a background of endometrial cancer treated with chemotherapy and radiotherapy 9 years ago. She was initially investigated with a pelvc MRI which showed a collection in the vaginal stump. A further abdominal and pelvic CT scan revealed a cholecystoduodenal fistula complicated by an ileovaginal fistula at the point of impaction. The patient underwent a laparotomy with small bowel resection and anastomosis. She was admitted to the intensive care unit post operatively and recovered well. There are no previous reports of a vaginal fistula caused by gallstone ileus. This case highlights a rare complication of gallstones in a patient who has undergone pelvic radiotherapy.

scholarly journals Gallstone ileus with an enterovaginal fistula: a rare complication of pelvic radiotherapy

2020 ◽  
Vol 6 (4) ◽  
pp. 20200060
Author(s):  
Luqman Wali ◽  
Fahd Husain ◽  
Sharmarke Ali ◽  
Sasha Humphries ◽  
Linda Turner ◽  
...  
Keyword(s):  
Small Bowel ◽  
Terminal Ileum ◽  
Unusual Case ◽  
Rare Complication ◽  
Gallstone Ileus ◽  
Late Complication ◽  
Fistula Formation ◽  
Pelvic Radiotherapy ◽  
Cholecystoduodenal Fistula ◽  
Enterovaginal Fistula

Gallstone ileus is a rare cause of small bowel obstruction. Chronic gallstone irritation can lead to the formation of a cholecystoduodenal fistula, with gallstone impaction typically in the terminal ileum. Rarely gallstones can become impacted in other structures such as the colon or can even erode through the bowel. We present an unusual case of a gallstone ileus which resulted in the formation of an enterovaginal fistula, secondary to previous pelvic radiotherapy. Our case highlights the importance of considering fistula formation as a late complication of radiotherapy and how this can alter expected features of other pathologies, such as a gallstone ileus.

scholarly journals A rare case of gallstone ileus—the unanswered question

2021 ◽  
Vol 2021 (4) ◽  
Author(s):  
Chi Fai Tsang
Keyword(s):  
Rare Complication ◽  
Gallstone Ileus ◽  
Gallstone Disease ◽  
Previous History ◽  
Emergency Laparotomy ◽  
Cholecystoduodenal Fistula ◽  
Biliary Surgery ◽  
Mechanical Intestinal Obstruction ◽  
History Of

Abstract Gallstone ileus is caused by an impaction of one or more gallstones within the gastrointestinal tract leading to mechanical intestinal obstruction. It is a rare complication of cholelithiasis and found in 2–3% of all cases associated with recurrent episodes of cholecystitis. This case study demonstrates an atypical presentation of gallstone ileus. A 57-year-old woman was presented with abdominal pain and vomiting without previous history of gallstone disease. The features of gallstone ileus are evident on computed tomography. She underwent an emergency laparotomy and enterotomy for the removal of impacting gallstones, followed by an interval cholecystectomy and cholecystoduodenal fistula closure. This case report aims to explore the proper surgical management of gallstone ileus. Unfortunately, the question of whether interval biliary surgery should be performed remains unanswered, and surgeons will continue to make the decision based on their clinical judgement.

1074 Gallstone Ileus: Two Decades After Cholecystectomy

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
K Matwala ◽  
M R Iqbal ◽  
T Shakir ◽  
D W Chicken
Keyword(s):  
Small Bowel ◽  
Bowel Obstruction ◽  
Rare Complication ◽  
Open Cholecystectomy ◽  
Gallstone Ileus ◽  
Proximal Small Bowel ◽  
Solid Diet ◽  
History Of ◽  
Ileocaecal Junction ◽  
Tomography Scan

Abstract Introduction Gallstone ileus is a rare complication of gallstones that occurs in 1%-4% of all cases of bowel obstruction. We present a surprising case of gallstone ileus causing small bowel obstruction 19 years after open cholecystectomy. Case Report A 77-year-old male presented with a 3-day history of abdominal pain, 4 episodes of vomiting and absolute constipation. He had a surgical background of an open cholecystectomy and open appendicectomy 19 years and 45 years ago respectively. Medically, he had well-controlled hypertension and experienced a TIA 5 years prior. Computed Tomography Scan of the abdomen and pelvis revealed features consistent with an obstructing, heterogenous opacity in the distal small bowel without pneumobilia. The patient subsequently underwent diagnostic laparoscopy. Intraoperatively, an obstructing gallstone, measuring 4 cm, was found 50cm proximal to the ileocaecal junction, with dilatation of the proximal small bowel and distal collapse. Enterotomy and removal of the stone was done. Post-operatively, this gentleman recovered without complications and was discharged home two days later after being able to tolerate a solid diet. Conclusions This is the second reported case of gallstone ileus in a patient with previous cholecystectomy about two decades ago, according to our literature search. Although extremely rare, absence of the gallbladder does not exclude the possibility of gallstone ileus.

scholarly journals A rare complication of cholecystolithiasis: perforation of the gallbladder

2021 ◽  
Vol 21 (84) ◽  
pp. e63-e66
Author(s):  
Bartosz Migda ◽  
◽  
Marlena Alicja Gabryelczak ◽  
Anna Migda ◽  
Katarzyna Prostacka ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Rare Complication ◽  
Gallstone Ileus ◽  
Mirizzi Syndrome ◽  
The Other ◽  
Gallbladder Perforation ◽  
Appropriate Care ◽  
History Of ◽  
Complications Of Cholelithiasis ◽  
Gallbladder Inflammation

Common complications of cholelithiasis include gallbladder inflammation, cholangitis, and acute pancreatitis. On the other hand, rare complications include gallbladder carcinoma, gallstone ileus, Mirizzi syndrome and gallbladder perforation. Some patients with cholecystitis do not require hospitalization. It is of key importance for proper further diagnosis and treatment to remember about the possible complications of cholecystitis, especially in oligosymptomatic patients. Therefore, ultrasound examinations in patients with a history of gallbladder stones should be performed with appropriate care. Ultrasound should be performed carefully in patients with a history of cholecystolithiasis, especially those oligosymptomatic, bearing in mind that there are some rare complications of this highly common clinical entity.

scholarly journals Tríada de Rigler radiológica en un caso de íleo biliar

2020 ◽  
Vol 112 (2) ◽  
pp. 203-204
Author(s):  
Martín Varela Vega ◽  
◽  
Micaela Mandacen ◽  
Andrés Pouy
Keyword(s):  
Gastrointestinal Tract ◽  
Small Bowel ◽  
Rare Complication ◽  
Gallstone Ileus ◽  
Mechanical Obstruction ◽  
Cholecystoduodenal Fistula ◽  
Radiographic Evidence ◽  
Rigler’S Triad

Background: gallstone ileus is a rare complication of cholelithiasis. It is defined as a mechanical obstruction of the small bowel due to impaction of large gallstones into the gastrointestinal tract, generally though a cholecystoduodenal fistula. Rigler’s triad (pneumobilia, ectopic gallstone and mechanical obstruction) occurs in 30% of the patients. Surgery is indicated and includes enterotomy with gallstone extraction. Objective: we report a case of gallstone ileus with radiographic evidence of Rigler’s triad

scholarly journals Bouveret Syndrome—The Rarest Variant of Gallstone Ileus: A Case Report and Literature Review

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Vasileios K. Mavroeidis ◽  
Dimitrios I. Matthioudakis ◽  
Nikolaos K. Economou ◽  
Ioannis D. Karanikas
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Gallstone Ileus ◽  
Surgical Techniques ◽  
Outlet Obstruction ◽  
Cholecystoduodenal Fistula ◽  
Endoscopic Techniques ◽  
History Of ◽  
Bouveret Syndrome ◽  
The Right

We present a case report of a patient with Bouveret syndrome with interesting radiological findings and successful surgical treatment after failure of the endoscopic techniques. The report is followed by a review of the literature regarding the diagnostic means and proper treatment of this rare entity. Bouveret syndrome refers to the condition of gastric outlet obstruction caused by the impaction of a large gallstone into the duodenum after passage through a cholecystoduodenal fistula. Many endoscopic and surgical techniques have been described in the management of this syndrome. This is a case of a 78-year-old patient with severe medical history who presented in bad general condition with an 8-day history of nausea, multiple bilious vomiting episodes, anorexia, discomfort in the right hypochondrium and epigastrium, and fever up to 38,5°C. The diagnosis of Bouveret syndrome was set after performing the proper imaging studies. An initial endoscopic effort to resolve the obstruction was performed without success. Surgical treatment managed to extract the impacted gallstone through an enterotomy after removal into the first part of the jejunum.

scholarly journals An Unusual Presentation of Cholecystoduodenal Fistula: Abdominal Pain out of Proportion to Exam

2019 ◽  
Vol 3 (3) ◽  
pp. 305-306
Author(s):  
Ryan McCreery ◽  
Matthew Meigh
Keyword(s):  
Abdominal Pain ◽  
Multimodality Imaging ◽  
Rare Complication ◽  
Gallbladder Disease ◽  
Final Diagnosis ◽  
Cholecystoduodenal Fistula ◽  
Case Presentation ◽  
History Of ◽  
Biliary Enteric Fistula ◽  
Specific Symptoms

Cholecystoduodenal fistula (CDF) is a rare complication of gallbladder disease. Clinical presentation is variable, and preoperative diagnosis is challenging due to the non-specific symptoms of CDF. We discuss a 61-year-old male with a history of atrial fibrillation who presented with severe abdominal pain out of proportion to exam. The patient was diagnosed promptly and successfully managed non-operatively. This case presentation emphasizes the need to maintain a broad differential diagnosis for abdominal pain out of proportion to exam, with the possibility of a biliary-enteric fistula as a possible cause. It also stresses the importance of a multimodality imaging approach to arrive at a final diagnosis.

scholarly journals Rectal prolapse: rare presentation and complication

2017 ◽  
Vol 4 (4) ◽  
pp. 1447
Author(s):  
Naueen Akbar Chaudhry ◽  
Kristina Go ◽  
Atif Iqbal
Keyword(s):  
Small Bowel ◽  
Rectal Prolapse ◽  
Bowel Resection ◽  
Small Bowel Resection ◽  
First Episode ◽  
Full Thickness ◽  
Rare Presentation ◽  
Perineal Rectosigmoidectomy ◽  
Altemeier Procedure ◽  
Resection And Anastomosis

An 86-year-old female presented with the first episode of an incarcerated full thickness rectal prolapse, concerning for ischemia of the prolapsed segment. Intra-operatively, the patient was noted to have an enterocele containing a 20-25 cm segment of strangulated and perforated small bowel. She underwent a perineal rectosigmoidectomy (altemeier procedure) with levatorplasty followed by a small bowel resection and anastomosis trans-abdominally.

Phaco-antigenic glaucoma following uncomplicated cataract surgery

2019 ◽  
Vol 29 (1_suppl) ◽  
pp. 22-26
Author(s):  
Alexander Kin Chiang Chiu ◽  
Divya Mathews
Keyword(s):  
Intraocular Pressure ◽  
Medical Treatment ◽  
Cataract Surgery ◽  
Surgical Procedure ◽  
Rare Complication ◽  
Case Description ◽  
Rare Presentation ◽  
History Of ◽  
The Right ◽  
Vitreous Biopsy

Introduction: Phaco-antigenic glaucoma occurs in less than 1% of cataract surgeries. Managing this rare complication is challenging, especially when there are few documented cases reported. We describe the challenges of managing a case of bilateral phaco-antigenic glaucoma following uncomplicated cataract surgery requiring viscocanalostomy. Case description: An 82-year-old atopic lady presented with a 2-day history of painful injected right eye. She was 4 days post left and 8 days post right uncomplicated cataract surgery. On examination, the anterior chambers were deep with no hypopyon. Intraocular pressure was raised at 38 mmHg in the right eye and 24 mmHg in the left eye initially. However, intraocular pressure remained uncontrolled despite maximum medical treatment; she attended A + E six times within 11 days with intraocular pressures of up to 48 mmHg in the right eye and 46 mmHg in the left eye. A vitreous biopsy was reported negative for infective organisms. Eventually, bilateral viscocanalostomies were performed and vision improved to 0.24 logMAR in both eyes with intraocular pressures of 8 mmHg in the right eye and 10 mmHg in the left eye. Conclusion: We present a rare presentation of phaco-antigenic glaucoma following an uncomplicated cataract surgical procedure with good results following timely intervention.

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