scholarly journals Gas in gallbladder—gallstone ileus?

2019 ◽  
Vol 2019 (8) ◽  
Author(s):  
Siang Wei Gan ◽  
Reizal Mohd Rosli ◽  
George Kiroff ◽  
Abdullah Muhammad Rana ◽  
Darren Tonkin
Keyword(s):  
Clinical Presentation ◽  
Gallstone Ileus ◽  
Gallstone Disease ◽  
Surgical Patients ◽  
Soft Tissue Density ◽  
Abdominal Radiography ◽  
Uncommon Presentation ◽  
Plain Abdominal Radiography ◽  
Surgical History ◽  
History Of

Abstract Gallstone ileus is an uncommon presentation among acute surgical patients. Its diagnosis is often delayed due to its non-specific clinical presentation. We report the case of an 81-year-old gentleman with a 2-day history of small bowel obstruction (SBO). He had a history of gallstone disease and no past surgical history. Plain abdominal radiography was consistent with SBO. A computed tomography (CT) abdomen scan would be warranted given the presentation of SBO in a virgin abdomen. However, this case emphasizes the importance of early CT imaging in a case of suspected gallstone ileus given that the diagnosis could not be made on plain abdominal radiography. CT abdomen is superior in detecting small amounts of gas and at discriminating soft tissue density.

scholarly journals Gallstone ileus managed with enterolithotomy

2019 ◽  
Vol 12 (10) ◽  
pp. e231581 ◽  
Author(s):  
Louise Dunphy ◽  
Ihsan Al-Shoek
Keyword(s):  
Small Bowel ◽  
Bowel Obstruction ◽  
Clinical Presentation ◽  
Gallstone Ileus ◽  
Gallstone Disease ◽  
Abdominal Radiograph ◽  
Ileocaecal Valve ◽  
History Of ◽  
Mechanical Bowel Obstruction ◽  
Pacemaker Insertion

Although gallstone disease is classically associated with the inflammatory sequela of cholecystitis, other presentations include gallstone ileus, Mirizzi syndrome, Bouveret syndrome and gallstone ileus. Gallstone ileus occurs when a gallstone passes from a cholecystoduodenal fistula into the gastrointestinal tract and causes obstruction, usually at the ileocaecal valve. It represents an uncommon complication of cholelithiasis, accounting for 1%–4% of all cases of mechanical bowel obstruction and 25% of all cases in individuals aged >65 years. It has a female predilection. Clinical presentation depends on the site of the obstruction. Diagnosis can prove challenging with the diagnosis rendered in 50% of cases intraoperatively. The authors present the case of a 79-year-old woman with a 10-day history of abdominal pain, nausea, vomiting and episodes of loose stools. An abdominal radiograph showed mildly distended right small bowel loops. Further investigation with a CT of the abdomen and pelvis demonstrated small bowel obstruction secondary to a 3.3 cm calculus within the small bowel. She underwent a laparotomy and a 5.0×2.5 cm gallstone was evident, causing complete obstruction. An enterolithotomy was performed. Her postoperative course was complicated by Mobitz type II heart block requiring pacemaker insertion. This paper will provide an overview of the clinical presentation, investigations and management of gallstone ileus. It provides a cautionary reminder of considering gallstone ileus in the differential diagnosis in elderly patients presenting with bowel obstruction and a history of gallstone disease.

CASE REPORT OF CHOLECYSTO-DUODENAL FSTULA BY GALLSTONE CAUSING SMALL BOWEL OBSTRUCTON AT KHANH HOA GENERAL HOSPITAL

2016 ◽  
pp. 25-30
Author(s):  
Vu Xuan Loc Doan ◽  
Tam Thanh Do
Keyword(s):  
Small Bowel ◽  
Clinical Presentation ◽  
Iliac Fossa ◽  
Gallstone Ileus ◽  
Computer Tomography Scan ◽  
History Of ◽  
Biliary Enteric Fistula ◽  
The Right ◽  
Tomography Scan

A rare but serious complication of cholecystolithiasis is the transition of a gallstone in the gastrointestinal tract through a biliary-enteric fistula, thereby causing a traffic mechanical obstruction of intestine. We report a case of cholecysto-duodenal fistula that causes small bowel obstruction by gallstone (gallstone ileus). A 35-year-old male patient with a history of type 1 diabetes and stroke sequelae, clinical presentation of intestinal obstruction with abdominal pain, vomiting, does not fart and defecate, abdominal distention. Multi-slice computer tomography scan of the abdomen shows large dilated small bowel loops containing airfluid levels, colon is in normal aspect, detects foreign body that is spherical and high density like target shape in the distal ileum loop at the right iliac fossa. Result of surgery is a big bile stone with 30mm in diameter located in the ileum loop.

Successful Treatment of Bouveret Syndrome Using Holmium: YAG Laser Lithotripsy

2005 ◽  
Vol 71 (10) ◽  
pp. 882-885 ◽  
Author(s):  
Evan B. Goldstein ◽  
Richard H. Savel ◽  
H. Leon Pachter ◽  
Jonathan Cohen ◽  
Peter Shamamian
Keyword(s):  
Yttrium Aluminum Garnet ◽  
Gallstone Ileus ◽  
Gallstone Disease ◽  
Outlet Obstruction ◽  
Abdominal Distension ◽  
Upper Esophageal Sphincter ◽  
Laser Lithotripsy ◽  
Yag Laser ◽  
History Of ◽  
Successful Removal

Although gallstone disease is highly prevalent, cholelithiasis causing gallstone ileus is uncommon. Consideration has been given for nonoperative strategies to resolve obstruction due to the significant age and comorbidities afflicting this population. A 94-year-old man presented with a 5-day history of abdominal distension and tenderness. CT scan revealed multiple large gallstones within the gallbladder, pneumobilia, and two ectopic gallstones (antrum of the stomach and distal ileum). The patient was taken to the operating room where an enterolithotomy and gastrotomy was performed with removal of gallstones and subsequent relief of obstruction. During the postoperative course, the patient developed symptoms of gastric outlet obstruction and underwent gastrointestinal endoscopy for diagnosis and treatment. Two large gallstones, present in the duodenum, were retracted into the stomach using a Roth net but could not be retrieved beyond the upper esophageal sphincter. A holmium: yttrium-aluminum-garnet (Holmium: YAG) laser was used for fragmentation of the stones, with subsequent successful removal. This is the first documented successful use of the holmium: YAG laser for the treatment of recurrent gallstone ileus. Physicians should remember that in a small but important subgroup of patients, endoscopy accompanied by laser lithotripsy may prove beneficial.

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.

scholarly journals Rolling in the Deep: Imaging Findings and Diagnostic Pearls in Gallstone Ileus

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Carnevale Aldo ◽  
Motta Lorenzo ◽  
Labaj Olgerta ◽  
Cossu Alberto ◽  
Uccelli Licia ◽  
...  
Keyword(s):  
Bowel Obstruction ◽  
Preoperative Planning ◽  
Gallstone Ileus ◽  
Gallstone Disease ◽  
High Morbidity ◽  
Resonance Imaging ◽  
Abdominal Radiography ◽  
Deep Imaging ◽  
Mechanical Intestinal Obstruction ◽  
Definition Of

Gallstone ileus is a dramatic complication of gallstone disease, uncommon but not exceptional in a busy emergency department. It represents a cause of mechanical intestinal obstruction, which predominantly occurs in elderly and frail patients; this contributes to the high morbidity and mortality rates associated with this condition. The modern radiologist is frequently asked to determine the cause of bowel obstruction and should be aware of the most pictorial features of this unusual disease. Broadly speaking, abdominal radiography and ultrasonography alone are limited in detecting the cause of bowel obstruction, but the sensitivity for the preoperative diagnosis of gallstone ileus may be improved by combining the findings obtained by both techniques. Computed tomography is the modality of choice for the diagnosis of this disease: it may accurately describe the number, size, and location of migrated gallstones and the exact site of bowel obstruction, providing a detailed preoperative planning. Magnetic resonance imaging may be used in selected cases for an exquisite anatomic definition of the fistulous communication.

Treatment of Harlequin Syndrome by Costotransversectomy and Sympathectomy: Case Report

Neurosurgery ◽  
2011 ◽  
Vol 69 (1) ◽  
pp. E257-E259 ◽  
Author(s):  
Eric Anthony Sribnick ◽  
Nicholas M Boulis
Keyword(s):  
Clinical Presentation ◽  
Radicular Pain ◽  
Sudden Onset ◽  
Curative Therapy ◽  
Harlequin Syndrome ◽  
Random Intervals ◽  
Surgical History ◽  
History Of ◽  
Case Presentations ◽  
The Brain

Abstract BACKGROUND AND IMPORTANCE: Harlequin syndrome is a rare neurological condition involving various degrees of unilateral hyperhidrosis and erythema of the head and neck. We present a clinical presentation and description of curative therapy in a patient with a sudden onset of Harlequin syndrome following a thoracotomy. CLINICAL PRESENTATION: A 42-year-old female with a history of mastectomy for right-sided breast cancer subsequently had a left partial pneumonectomy for a metastasis. Postoperatively, she had onset of contralateral neck and facial flushing and sweating. Flushing was triggered by emotion and exercise, but also occurred spontaneously at random intervals. Magnetic resonance imaging of the brain, cervical spine, and thoracic spine were negative for pathology. Because of the patient's surgical history and negative workup, she was given a diagnosis of Harlequin syndrome. Surgical intervention consisted of a partial right T3 costotransversectomy with T2 sympathectomy. Postoperatively, the patient's symptoms of Harlequin syndrome resolved. The procedure was complicated by T1 radicular pain, which responded well to Gabapentin. CONCLUSION: The diagnosis of Harlequin syndrome is relatively new, and the majority of the scientific literature is concerned with descriptive case presentations. We present a surgical technique for the treatment of Harlequin syndrome.

scholarly journals Natural and surgical history of Chiari malformation Type I in the pediatric population

2016 ◽  
Vol 17 (3) ◽  
pp. 343-352 ◽  
Author(s):  
I. Jonathan Pomeraniec ◽  
Alexander Ksendzovsky ◽  
Ahmed J. Awad ◽  
Francis Fezeu ◽  
John A. Jane
Keyword(s):  
Chiari Malformation ◽  
Pediatric Patients ◽  
Surgical Patients ◽  
Type I ◽  
Chiari Malformation Type I ◽  
Conservative Group ◽  
Significant Difference ◽  
Surgical History ◽  
History Of ◽  
Dural Opening

OBJECT The natural and surgical history of Chiari malformation Type I (CM-I) in pediatric patients is currently not well described. In this study the authors discuss the clinical and radiological presentation and outcomes in a large cohort of pediatric CM-I patients treated with either conservative or surgical management. METHODS The authors retrospectively reviewed 95 cases involving pediatric patients with CM-I who presented between 2004 and 2013. The patients ranged in age from 9 months to 18 years (mean 8 years) at presentation. The cohort was evenly split between the sexes. Twenty-five patients underwent posterior fossa decompression (PFD) with either dural splitting or duraplasty. Seventy patients were managed without surgery. Patients were followed radiologically (mean 44.8 months, range 1.2–196.6 months) and clinically (mean 66.3 months, range 1.2–106.5 months). RESULTS Seventy patients were treated conservatively and followed with serial outpatient neurological and radiological examinations, whereas 25 patients were treated with PFD. Of these 25 surgical patients, 11 were treated with duraplasty (complete dural opening) and 14 were treated with a dura-splitting technique (incomplete dural opening). Surgical intervention was associated with better clinical resolution of symptoms and radiological resolution of tonsillar ectopia and syringomyelia (p = 0.0392). Over the course of follow-up, 20 (41.7%) of 48 nonsurgical patients who were symptomatic at presentation experienced improvement in symptoms and 18 (75%) of 24 symptomatic surgical patients showed clinical improvement (p = 0.0117). There was no statistically significant difference in resolution of symptoms between duraplasty and dura-splitting techniques (p = 0.3572) or between patients who underwent tonsillectomy and tonsillopexy (p = 0.1667). Neither of the 2 patients in the conservative group with syrinx at presentation showed radiological evidence of resolution of the syrinx, whereas 14 (87.5%) of 16 patients treated with surgery showed improvement or complete resolution of syringomyelia (p = 0.0392). In the nonsurgical cohort, 3 patients (4.3%) developed new or increased syrinx. CONCLUSIONS The overwhelming majority of CM-I patients (92.9%) managed conservatively do not experience clinical or radiological progression, and a sizeable minority (41.7%) of those who present with symptoms improve. However, appropriately selected symptomatic patients (sleep apnea and dysphagia) and those presenting with syringomyelia should be considered surgical candidates because of the high rates of clinical (75%) and radiological improvement (87.5%).

scholarly journals Surgical Management of Gallstone Ileus in Low-Settings Hospital during COVID-19 Outbreak: A Case Report

2021 ◽  
Vol 07 (02) ◽  
pp. e54-e58
Author(s):  
Ghaith Al-Abbasi ◽  
Ali Adil Alhilfy ◽  
Ameer Al-Jasim
Keyword(s):  
Gallstone Ileus ◽  
Gallstone Disease ◽  
Elevated Serum ◽  
White Female ◽  
Case Presentation ◽  
Distended Abdomen ◽  
History Of ◽  
Crampy Abdominal Pain ◽  
Pass Through

Abstract Introduction Gallstone ileus is a very infrequent complication of cholelithiasis in which single or multiple stones pass through an abnormal fistula to the lumen of the intestine leading to a true mechanical obstruction. We are reporting a case of a female who developed intestinal obstruction due to gallstones during the coronavirus disease 2019 (COVID-19) outbreak and was managed urgently surgically in a low-settings hospital. Case Presentation An 85-year-old white female with 40 years history of gallstone disease, hypertension, and type-2 diabetes presented to the accidents and emergency unit with upper central crampy abdominal pain for 5 days associated with green color vomiting and absolute constipation. On examination, she was barely stable, dehydrated, had a distended abdomen, and guarding in the epigastric region. Her electrolytes were disturbed and had elevated serum creatinine and blood urea. Imaging studies confirmed gallstone ileus. Management was surgical despite the lack of facilities and equipment including COVID-19 personal protective equipment. Conclusion Despite being an infrequent complication, gallstone ileus might present at the most unexpected time and in the least equipped hospital where the surgeon's suspicion, risk stratification, and improvisation by utilizing what is available are the keys for successful management and saving lives.

Surgical management of choke through oesophagotomy in a buffalo: A case report

2017 ◽  
Vol 12 (3) ◽  
Author(s):  
Devasee Borakhatariya ◽  
A. B. Gadara
Keyword(s):  
Case Report ◽  
Surgical Management ◽  
Clinical Presentation ◽  
Clinical Signs ◽  
Thoracic Inlet ◽  
Cervical Oesophagus ◽  
Foreign Objects ◽  
History Of ◽  
Oesophageal Obstruction ◽  
Large Animals

Oesophageal disorders are relatively uncommon in large animals. Oesophageal obstruction is the most frequently encountered clinical presentation in bovine and it may be intraluminal or extra luminal (Haven, 1990). Intraluminal obstruction or “choke” is the most common abnormality that usually occurs when foreign objects, large feedstuff, medicated boluses, trichobezoars, or oesophageal granuloma lodge in the lumen of the oesophagus. Oesophageal obstructions in bovine commonly occur at the pharynx, the cranial aspect of the cervical oesophagus, the thoracic inlet, or the base of the heart (Choudhary et al., 2010). Diagnosis of such problem depends on the history of eating particular foodstuff and clinical signs as bloat, tenesmus, retching, and salivation

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