scholarly journals A case of successful conservative management of gallstone ileus

2019 ◽  
Vol 2019 (8) ◽  
Author(s):  
Sherif Monib ◽  
Mohamed Elkorety ◽  
Simon Thomson
Keyword(s):  
Small Intestine ◽  
Conservative Treatment ◽  
Bowel Obstruction ◽  
Conservative Management ◽  
Clinical Picture ◽  
Gallstone Ileus ◽  
The Elderly ◽  
Mechanical Bowel Obstruction ◽  
Uncommon Complication

Abstract Gallstone ileus is an uncommon complication of cholelithiasis but an established cause of mechanical bowel obstruction in the elderly. Perforation of the small intestine proximal to the obstructing gallstone is rare, only a handful of cases having been reported. Management is mainly surgical, but conservative treatment is occasionally appropriate. We report the case of an 86-year-old female who presented with a clinical picture of bowel obstruction, proven to be related to gallstone ileus which resolved spontaneously. We discuss the role of conservative management for this condition.

scholarly journals A case of colonic gallstone ileus with a spontaneous evacuation

1970 ◽  
Vol 9 (1) ◽  
pp. 47-49 ◽  
Author(s):  
A Bajracharya ◽  
OP Pathania ◽  
S Adhikary ◽  
CS Agrawal
Keyword(s):  
Bowel Obstruction ◽  
Large Bowel ◽  
Gallstone Ileus ◽  
Abdominal Distension ◽  
The Elderly ◽  
Large Bowel Obstruction ◽  
High Morbidity ◽  
Diagnostic Challenge ◽  
History Of ◽  
Spontaneous Evacuation

Colonic gallstone is an uncommon entity with a high morbidity and mortality due to various reasons. It remains a diagnostic challenge because of delayed and non-specific presentations, especially in the elderly population, often with multiple co-morbidities. We present a case of colonic gallstone ileus with spontaneous evacuation in a 67 years female who had a threeday history of intermittent bouts of colicky abdominal pain, vomiting , constipation and progressive abdominal distension, features of large bowel obstruction treated non operatively for 72 hours and passage of the stone spontaneously. Keywords: gallstone ileus; large bowel obstruction; colonic gallstone DOI: 10.3126/hren.v9i1.4363Health Renaissance, 2011: Vol.9 No.1:47-49

scholarly journals Large Bowel Obstruction Due to a Big Gallstone Successfully Treated with Endoscopic Mechanical Lithotripsy

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Marco Balzarini ◽  
Laura Broglia ◽  
Giovanni Comi ◽  
Calcedonio Calcara
Keyword(s):  
High Risk ◽  
Sigmoid Colon ◽  
Surgical Management ◽  
Bowel Obstruction ◽  
Large Bowel ◽  
Colonic Obstruction ◽  
Gallstone Ileus ◽  
Large Bowel Obstruction ◽  
Mechanical Lithotripsy ◽  
Mechanical Bowel Obstruction

Colonic gallstone ileus in an uncommon mechanical bowel obstruction caused by intraluminal impaction of one or more gallstones. The surgical management of gallstone ileus is complex and is potentially of high risk. There have been reports of gallstone extractions using various endoscopic modalities to relieve the obstruction. In this report we present the technique employed to successfully perform a mechanical lithotripsy and extraction of a large gallstone embedded in a sigmoid colon affected by diverticular stenosis. We passed through the stenosis with a 11.3 mm videoscope with 3.7 mm channel. A large lithotripsy extraction basket was used to catch and break up the stone and fragments were removed using the same basket. The patient was discharged asymptomatic three days after the procedure. Using appropriate devices mechanical lithotripsy is a safe and effective method to treat colonic obstruction and avoid surgery in the setting of gallstone ileus even in case of big stones.

scholarly journals Laparoscopic Treatment of Gallstone Ileus

2014 ◽  
Vol 7 ◽  
pp. CCRep.S16512 ◽  
Author(s):  
Huseyin Y. Bircan ◽  
Bora Koc ◽  
Umit Ozcelik ◽  
Ozgur Kemik ◽  
Alp Demirag
Keyword(s):  
Intestinal Obstruction ◽  
Bowel Obstruction ◽  
Intestinal Tract ◽  
Rare Complication ◽  
Gallstone Ileus ◽  
High Morbidity ◽  
Enteric Fistula ◽  
Laparoscopic Treatment ◽  
Mechanical Bowel Obstruction ◽  
Biliary Enteric Fistula

Gallstone ileus is a rare complication of cholelithiasis that has high morbidity and mortality. An intestinal obstruction can be caused by migration of a large gallstone through a biliary enteric fistula or by impaction within the intestinal tract. In this study, we present the case of an 81-year-old woman with a mechanical bowel obstruction by a gallstone that was treated by laparoscopy.

scholarly journals Gallstone ileus: a not-so-rare cause of bowel obstruction in the elderly

2012 ◽  
Vol 2012 (nov22 2) ◽  
pp. bcr0220125756-bcr0220125756
Author(s):  
A. O. Noah ◽  
A. Wadoodi ◽  
O. Priest
Keyword(s):  
Bowel Obstruction ◽  
Gallstone Ileus ◽  
The Elderly

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.

scholarly journals Gallstone Ileus With Jejunum Perforation Managed With Laparoscopic-Assisted Surgery: Rare Case Report and Minimal Invasive Management

2015 ◽  
Vol 100 (5) ◽  
pp. 878-881 ◽  
Author(s):  
Cheng-Hung Lee ◽  
Wen-Yao Yin ◽  
Jian-Han Chen
Keyword(s):  
Small Bowel ◽  
Bowel Obstruction ◽  
Gallstone Ileus ◽  
Correct Diagnosis ◽  
Laparoscopic Approach ◽  
Small Bowel Resection ◽  
Minimal Invasive ◽  
Rare Case Report ◽  
Laparoscopic Assisted ◽  
Uncommon Complication

Gallstone ileus is an uncommon complication of cholelithiasis. Most patients affected by gallstone ileus are elderly and have multiple comorbidities. Symptoms are vague and insidious, which may delay the correct diagnosis for days. Here we are reporting an uncommon complication of gallstone ileus. We report on a 70-year-old man with small bowel obstruction at the jejunum due to an impacted stone, which led to necrosis and perforation of the proximal bowel wall. Laparoscope-assisted small bowel resection with enterolithotomy was used to successfully treat the patient's perforation and obstruction. His recovery was uneventful. Gallstone ileus commonly presents with bowel obstruction, but intestinal perforation occurs very rarely. A laparoscopic approach can provide both diagnostic and therapeutic roles in management.

scholarly journals Acetabular fractures in the elderly: modern challenges and the role of conservative management

2021 ◽  
Author(s):  
Kunal Mohan ◽  
James M. Broderick ◽  
Hasnain Raza ◽  
Brendan O’Daly ◽  
Michael Leonard
Keyword(s):  
Conservative Management ◽  
Young Patients ◽  
Treatment Strategies ◽  
The Elderly ◽  
High Energy ◽  
Acetabular Fractures ◽  
Individualized Approach ◽  
Vulnerable Patient ◽  
Vulnerable Patient Group

Abstract Introduction  The incidence of acetabular fractures in the elderly population is ever increasing. While management of acetabular fractures in young patients following high-energy trauma is well described, treatment of the elderly patient subgroup is complex and requires a unique, individualized approach. A variety of treatment strategies including operative and non-operative approaches exists to manage this vulnerable patient group. Conservative management of acetabular fractures in the elderly continues to play an important role in treatment of both stable fracture patterns and those medically unfit for surgery. Aim  This review assessing the current literature was undertaken with the purpose of summarising the challenges of management in this at-risk cohort as well as quantifying the role and outcomes following conservative management in the elderly.  Conclusion Our recommendation is that conservative management of acetabular fractures in the elderly can be considered as a treatment option on a case-by-case basis accounting for patient, injury, and surgical factors. If it is to be pursued, we advise a multidisciplinary approach focused on early mobility, minimisation of risk and regular follow-up to optimise patient outcomes.

scholarly journals Gallstone Ileus: A Rare Cause of Intraluminal Small Bowel Obstruction

2021 ◽  
pp. 1-2
Author(s):  
Alyssa Chong Li ◽  
◽  
Reuben Ndegwa Ndegwa ◽  
Goutham Sivasuthan ◽  
◽  
...  
Keyword(s):  
Bowel Obstruction ◽  
Gallstone Ileus ◽  
Current Smoker ◽  
Computerised Tomography ◽  
Quadrant Pain ◽  
Female Population ◽  
Case Presentation ◽  
Mechanical Intestinal Obstruction ◽  
Mechanical Bowel Obstruction

Background: Gallstone ileus is mechanical intestinal obstruction secondary to impaction of a gallstone within the gastrointestinal tract, and accounts for 1-4% of mechanical bowel obstruction, with a preponderance in the female population [1]. Case Presentation: 56 year-old female presented with right upper quadrant pain (RUQ) and multiple vomits, current smoker. Mechanical obstruction noted on computerised-tomography and underwent laparotomy revealing gallstone ileus. This is on a background of two prior episodes of RUQ pain, presenting to the hospital but lost of follow-up after discharging against medical advice two years ago

scholarly journals Conservative Management of Complicated Colonic Diverticulitis in Early and Late Elderly

Medicina ◽  
2021 ◽  
Vol 58 (1) ◽  
pp. 29
Author(s):  
Gennaro Perrone ◽  
Mario Giuffrida ◽  
Elena Bonati ◽  
Gabriele Luciano Petracca ◽  
Antonio Tarasconi ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Elderly Patients ◽  
Conservative Management ◽  
Acute Diverticulitis ◽  
The Elderly ◽  
Complicated Diverticulitis ◽  
First Episode ◽  
Colonic Diverticulitis ◽  
Acute Colonic Diverticulitis

Background and Objectives: The management of complicated diverticulitis in the elderly can be a challenge and initial non-operative treatment remains controversial. In this study, we investigate the effectiveness of conservative treatment in elderly people after the first episode of complicated diverticulitis. Materials and Methods: This retrospective single-centre study describes 71 cases of elderly patients with complicated acute colonic diverticulitis treated with conservative management at Parma University Hospital from 1 January 2012 to 31 December 2019. Diverticulitis severity was staged according to WSES CT driven classification for acute diverticulitis. Patients was divided into two groups: early (65–74 yo) and late elderly (>75 yo). Results: We enrolled 71 elderly patients conservatively treated for complicated acute colonic diverticulitis, 25 males and 46 females. The mean age was 74.78 ± 6.8 years (range 65–92). Localized abdominal pain and fever were the most common symptoms reported in 34 cases (47.88%). Average white cells count was 10.04 ± 5.05 × 109/L in the early elderly group and 11.24 ± 7.89 in the late elderly group. CRP was elevated in 29 (78.3%) cases in early elderly and in 23 late elderly patients (67.6%). A CT scan of the abdomen was performed in every case (100%). Almost all patients were treated with bowel rest and antibiotics (95.7%). Average length of stay was 7.74 ± 7.1 days (range 1–48). Thirty-day hospital readmission and mortality were not reported. Average follow-up was 52.32 ± 31.8 months. During follow-up, home therapy was prescribed in 48 cases (67.6%). New episodes of acute diverticulitis were reported in 20 patients (28.1%), elevated WBC and chronic NSAID therapy were related to a higher risk of recurrence in early elderly patients (p < 0.05). Stage IIb-III with elevated WBC during first episode, had a higher recurrence rate compared to the other CT-stage (p = 0.006). Conclusions: The management of ACD in the elderly can be a challenge. Conservative treatment is safe and effective in older patients, avoiding unnecessary surgery that can lead to unexpected complications due to co-morbidities.

scholarly journals The role of small intestine in pathogenesis of common variable immune deficiency

2018 ◽  
Vol 90 (2) ◽  
pp. 43-46
Author(s):  
L M Krums ◽  
A I Parfenov ◽  
R B Gudkova ◽  
S V Bykova ◽  
E A Sabelnikova
Keyword(s):  
Immune Deficiency ◽  
Small Intestine ◽  
Blood Serum ◽  
Clinical Picture ◽  
Digestive System ◽  
Morphological Structure ◽  
Pathological Process ◽  
Common Variable Immune Deficiency ◽  
Common Variable

The article presents the results of examination of 32 patients with common variable immune deficiency (barn) with involvement in the pathological process of the digestive system. The features of the clinical picture, the content of immunoglobulins in the blood serum, morphological structure of the mucosa of small intestine as well as treatment. Special attention is paid to the small intestine in the pathogenesis of the barn.

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