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

563 A Rare Case of Small Bowel Obstruction Secondary to Peritoneal Encapsulation, Congenital Adhesional Band and Gallstone Ileus

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
P Gungadin ◽  
A Taib ◽  
M Ahmed ◽  
A Sultana
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Unusual Case ◽  
Gallstone Ileus ◽  
Gall Stone ◽  
Case Presentation ◽  
Peritoneal Encapsulation ◽  
History Of ◽  
Gall Stone Ileus

Abstract Introduction Small bowel obstruction can be caused by multiple factors. We describe an unusual case of small bowel obstruction secondary to three rare factors: gallstone ileus, peritoneal encapsulation and congenital adhesional band. Case Presentation A seventy-nine-year-old male presented with a four-day history of obstipation and abdominal pain. CT abdomen pelvis revealed small bowel obstruction secondary to gallstone ileus. The patient was managed by laparotomy. The intraoperative findings revealed the presence of a congenital peritoneal encapsulation with an adhesional band and gallstone proximal to the ileo-caecal valve. Although there was some dusky small bowel, this recovered following the release of the band. Discussion Peritoneal Encapsulation is a rare congenital pathology resulting in the formation of an accessory peritoneal membrane around the small bowel. This condition is asymptomatic and rarely presents as small bowel obstruction. The diagnosis is often made at laparotomy. There are less than 60 cases reported in literature. Gallstone ileus is another rare entity caused by an inflamed gallbladder adhering to part of the bowel resulting in a fistula. Conclusions The rarity of these conditions mean that they are poorly understood. A combination of this triad of gall stone ileus in the presence of peritoneal encapsulation and congenital band has not been reported before. Knowledge of this would raise awareness, facilitate diagnosis and management of patients.

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 Gallstone Ileus: An Unlikely Cause of Mechanical Small Bowel Obstruction

2017 ◽  
Vol 11 (2) ◽  
pp. 389-395 ◽  
Author(s):  
Estela Abich ◽  
Daniel Glotzer ◽  
Edward Murphy
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Gallstone Ileus ◽  
Abdominal Distension ◽  
Acute Onset ◽  
Female Population ◽  
Coffee Ground ◽  
Intestinal Obstructions ◽  
Emergent Laparotomy

Gallstone ileus is a rare disease that accounts for 1–4% of intestinal obstructions. Almost exclusively a condition in the older female population, it is a difficult diagnosis to make. We report the case of gallstone ileus in a 94-year-old Caucasian female, who presented to the emergency department with acute-onset nausea, coffee-ground emesis, lack of bowel movement, and abdominal distension. On CT scan, the diagnosis of gallstone ileus was made by the presence of a cholecystoduodenal fistula, pneumobilia, and small bowel obstruction. Emergent laparotomy with a one-stage procedure of enterolithotomy and stone removal by milking the bowel distal to the stone were performed. The postoperative course was uneventful until postoperative day 4 when the patient was found tachycardic, lethargic, and unresponsive. We reviewed the literature on the diagnosis and treatment of gallstone ileus.

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 Case Report

2020 ◽  
Vol 8 (C) ◽  
pp. 121-124
Author(s):  
Darmadi Darmadi ◽  
Riska Habriel Ruslie ◽  
Carolus Trianda Samosir
Keyword(s):  
Case Report ◽  
Mortality Rate ◽  
Bowel Obstruction ◽  
High Mortality ◽  
Medical Condition ◽  
Gallstone Ileus ◽  
Exploratory Laparotomy ◽  
Water Soluble ◽  
Intestinal Lumen ◽  
Female Population

BACKGROUND: Gallstone ileus (GI) is a mechanical obstruction in the intestinal lumen due to gallstones. Its prevalence is very low, but it possesses a high mortality rate. It is commonly found in older female population. CASE REPORT: We reported a case of GI in a 61-year-old Chinese female, who presented with acute onset of abdominal pain, nausea, and intermittent vomiting. On water-soluble contrast follow-through examination, she showed total bowel obstruction on the level of terminal ileum due to suspected gallstone. Exploratory laparotomy with procedure of enterolithotomy and stone removal by milking the bowel distal to the stone were performed. Post-operative course was uneventful, but the patient was discharged at post-operative day 8. Furthermore, the patient underwent cholecystectomy and fistula repair in the following days (two-stage surgery). She was followed up in the clinic for 12 months and the patient remained asymptomatic. CONCLUSION: GI is a rare medical condition with a high mortality rate, commonly affecting females and elder population. It must be considered in a patient with bowel obstruction, especially with a history of cholelithiasis. Many clinicians prefer enterolithotomy alone, followed by cholecystectomy at later date, because of its lower morbidity and report high spontaneous fistula closure.

Endometrial tumour as a cause of mechanical bowel obstruction – a case report

Nowa Medycyna ◽  
2018 ◽  
Vol 25 (4) ◽  
Author(s):  
Sławomir Glinkowski ◽  
Daria Marcinkowska
Keyword(s):  
Bowel Obstruction ◽  
Histopathological Examination ◽  
Positive Family History ◽  
Child Bearing ◽  
Surgical Ward ◽  
Fluid Supplementation ◽  
Uterine Ligaments ◽  
Mechanical Bowel Obstruction ◽  
The Right

Endometriosis is a disease that involves the presence of physiologically active uterine tissue beyond the uterus. It is classified as a non-malignant disease that typically develops within the reproductive system: in the ovaries, fallopian tubes, or uterine ligaments. These changes tend to occur also beyond the reproductive structures, usually within the digestive system, where the most common sites are the peritoneum, postsurgical scars or umbilicus. Moreover, the disease can occur in the intestine, usually in the large bowel, and particularly in the caecum. The literature reports that endometriosis may affect even 10% of women of child-bearing age. The authors present a case of a patient admitted to the surgical ward due to mechanical bowel obstruction. Intraoperatively, an endophytic tumour, completely occluding the ileum, was found. Due to its location, i.e. approximately 15 cm from the Bauhin’s valve, it was resected together with the ascending colon and the right half of the transverse colon. Based on the morphology of the lesion and a positive family history, cancer was thought to be the most probable cause of the patient’s symptoms. The result of the histopathological examination did not confirm this, however. The specimen showed endometriosis. On the day of surgery, the patient was administered antibiotics, total parenteral nutrition and essential fluid supplementation. The wound healed normally, and abdominal pain did not return as diet was being extended. The patient was discharged on the 6th day after the operation with recommended follow-up in a surgical clinic.

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 Diagnosis and treatment of gallstone intestinal obstruction in an adult patient

2021 ◽  
Vol 9 (2) ◽  
pp. 090-094
Author(s):  
Fatin R. Polat ◽  
Ilhan Bali ◽  
Yasin Duran ◽  
Suat Benek
Keyword(s):  
Intestinal Obstruction ◽  
Gallstone Ileus ◽  
Biliary Colic ◽  
Two Stage ◽  
Abdominal Ct ◽  
Case Presentation ◽  
Mechanical Intestinal Obstruction ◽  
History Of ◽  
Surgery First ◽  
Bowel Dilatation

Background: Gallstone ileus, which is called Type Vb Mirizzi Syndrome, is a rare case of mechanical intestinal obstruction observed in older patients with history of cholelithiasis or cholecystitis. Diagnostic Imaging plays an important role in the management of patients with suspected gallstone ileus. X-Ray and Abdominal Computed Tomography (CT) are the preferred modality. Case presentation: The patient was diagnosed with gallstone ileus at the age of 45. The case had 10 years history of biliary colic disease. The patient who is suffered from intestinal obstruction. CT demonstrated pneumobilia involving the gallbladder, a 5, 5 cm calcified stone in the ileum and small bowel dilatation. He underwent enterolithotomy and a huge stone was removed. When gallbladder area was checked, the gallbladder was highly adherent (to colon and stomach) and was inflamed. We suspected malignancy so multipl biopsy was taken. Two-stage treatment model was planned. After the surgery, any emerging complications were closely monitored. Conclusions: Abdominal CT are the preferred modality for diagnosis. The main treatment for gallstone intestinal obstruction is surgery. First step enterotomy, later intented for the gallbladder. There are two type of surgical approach for gallbladder: one-stage treatment or two-stage treatment according the inflammation of gallbladder

EP.FRI.614 An Atypical Case of Small Bowel Obstruction in the Virgin Abdomen: Case Presentation and Literature Review

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Tarak Chouari ◽  
Hamza Khan ◽  
Tanzeela Gala ◽  
Serena Ceraldi
Keyword(s):  
Small Bowel ◽  
Literature Review ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Treatment Algorithm ◽  
Operative Management ◽  
Case Presentation ◽  
Atypical Case ◽  
Low Threshold

Abstract Aims The management of post-operative adhesional small bowel obstruction (SBO) has shifted from the historical motto of “the sun should never rise and set on a complete SBO” to a non operative approach in selected patients. Despite this shift, the operative management of patients with SBO with a virgin abdomen is still encouraged.  Methods We present an atypical case of SBO managed conservatively with resolution, without surgical intervention. A literature review is conducted and our case compared with the current literature. A treatment algorithm is presented.  Results A 57 year old with a virgin abdomen presented with vomiting and abdominal pain. Computed tomography was consistent with mid to distal SBO proximal to the terminal ileum, in the context of a high riding caecum. He was managed conservatively. Symptoms resolved within 12 hours without gastrograffin. Gastrograffin was subsequently given to ensure contrast was present in the large bowel. At 6 month follow up he remains symptom free. Discussion Many advocate surgery is the cornerstone of the management of SBO in the virgin abdomen. There is little evidence to support this. Recent emerging evidence challenges this view. Ultimately the clinical evaluation of the patient is paramount in selecting which patients can be managed conservatively. A longer interval to operation may carry greater risk of ischaemia and bowel resection. Therefore careful patient selection and serial examination is vital and one should have a low threshold for early operative intervention in the patient which isn't settling. Follow up should be tailored to each patient.

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