scholarly journals Gallstone Ileus with Resolution of Bile Leak Post-Subtotal Cholecystectomy and Spontaneous Closure of Cholecystoduodenal Fistula: Case Report and Literature Review

2021 ◽  
Author(s):  
Jessy Ng Suk Ning ◽  
Satkunan Mark ◽  
Yan Yang Wai
Keyword(s):  
Bowel Obstruction ◽  
Gallstone Ileus ◽  
Bile Leak ◽  
Spontaneous Closure ◽  
Gallbladder Perforation ◽  
Cholecystoduodenal Fistula ◽  
Biliary Calculi ◽  
Post Surgery ◽  
Post Operation ◽  
Rigler’S Triad

Gallstone ileus (GSI) is a mechanical intraluminal bowel obstruction caused by biliary calculi through the biliary-enteric fistula. This is a rare sequela of cholelithiasis occurring in 0.3 – 1.5% of patients with worrying mortality of 11.7 – 20%. This is a case of GSI in a 67-year-old woman who presented with small bowel obstruction secondary to impaction of biliary calculi at terminal ileum with underlying cholecystoduodenal fistula (CDF). Enterolithotomy with stone extraction (ES) was performed, followed by subtotal reconstituting cholecystectomy due to iatrogenic gallbladder perforation. The diagnosis of GSI is ascertained by the presence of the Rigler’s triad on abdominal X-ray, while CDF was demonstrated by post-surgery CT images. Bile leak post-operation was managed conservatively based on the SNAP (Sepsis, Nutrition, Anatomy, Plan) approach, and spontaneous closure of CDF was observed. In a nutshell, GSI should always be kept in mind as a differential diagnosis of mechanical bowel obstruction, especially among elderly female patients. Radiological findings of Rigler’s triad aid clinical diagnosis of GSI. Despite its rare incidence, early diagnosis is crucial as it is readily treatable with surgery. ES alone is the gold standard in the management of GSI.

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 Bowel obstruction secondary to gallstone ileus within an inguinoscrotal hernia: a rare diagnosis in an elderly patient

2021 ◽  
pp. 20200207
Author(s):  
Nisham Ghimire ◽  
Diogo JV Silva ◽  
Akshay Bavikatte ◽  
Mojolaoluwa Olugbemi ◽  
Ami Mishra ◽  
...  
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Gallstone Ileus ◽  
Cholecystoduodenal Fistula ◽  
Elderly Male ◽  
Unique Case ◽  
Inguinoscrotal Hernia ◽  
Common Causes ◽  
Rare Diagnosis

Gallstone ileus and obstructed inguinal hernias are respectively, rare and common causes of small bowel obstruction. There are no published cases of these pathologies occurring simultaneously. Here, we describe a unique case of an elderly male patient presenting with a small bowel obstruction caused by these combined pathologies. Following an acute presentation with obstructive symptoms, a CT scan demonstrated small bowel obstruction due to a large gallstone lodged in the neck of an inguinoscrotal hernia with associated pneumobilia. The case may have been managed conservatively if it was not for the presence of the gallstone. Previous imaging had incidentally demonstrated gallstones in the gallbladder and a large uncomplicated right inguinoscrotal hernia. It is presumed that a cholecystoduodenal fistula formed and a gallstone then migrated downstream to lodge within the neck of the inguinoscrotal hernia. This case underscores the concept that even in the presence of an “obvious” cause of small bowel obstruction, such as an irreducible, large inguinoscrotal hernia, we must always maintain a healthy clinical skepticism and an open mind to other unexpected aetiologies, which may account for the clinical presentation that might impact subsequent management.

scholarly journals Rigler's triad in gallstone ileus: a rare form of bowel obstruction

2016 ◽  
Vol 81 (2) ◽  
pp. 103-104 ◽  
Author(s):  
M.M. Ramírez-Ramírez ◽  
E. Villanueva-Saenz ◽  
G. Zubieta-Ófarril
Keyword(s):  
Bowel Obstruction ◽  
Gallstone Ileus ◽  
Rare Form ◽  
Rigler’S Triad

scholarly journals A case of gallstone ileus displaying spontaneous closure of cholecystoduodenal fistula after enterolithotomy

2012 ◽  
Vol 3 (1) ◽  
pp. 12-15 ◽  
Author(s):  
Yoshihiro Shioi ◽  
Shuji Kawamura ◽  
Kiminori Kanno ◽  
Yutaka Nishinari ◽  
Kousei Ikeda ◽  
...  
Keyword(s):  
Gallstone Ileus ◽  
Spontaneous Closure ◽  
Cholecystoduodenal Fistula

scholarly journals Spontaneous cholecystoduodenal fistula - spectrum of complications

2019 ◽  
Vol 147 (9-10) ◽  
pp. 628-631
Author(s):  
Dusan Saponjski ◽  
Aleksandra Djuric-Stefanovic ◽  
Aleksandra Jankovic ◽  
Milica Mitrovic-Jovanovic ◽  
Stefan Kmezic ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Magnetic Resonance ◽  
Bowel Obstruction ◽  
Gallstone Ileus ◽  
Duodenal Bulb ◽  
Cholecystoduodenal Fistula ◽  
X Ray ◽  
Persistent Abdominal Pain ◽  
First Choice ◽  
Bouveret Syndrome

Introduction. Spontaneous cholecystoduodenal fistula is a rare complication of the gallbladder calculosis. Bowel obstruction is the complication in less than 1% of these patients. The pathognomonic triad (Rigler triad) of pneumobilia, small-bowel distention, and ectopic gallstones is typical for gallstone ileus. In only 1?3% of the patients with bowel obstruction by ectopic gallstone the localization of obstruction is in the duodenum, and it is called Bouveret syndrome. The rarest complication is a floating non-obstructing gallstone trapped in the stomach. Outline of cases. We present three elderly female patients with persistent abdominal pain and known gallbladder calculosis in the patients? histories. Plain radiography of the thorax and abdomen and ultrasound were performed as the first choice and contrast-enhanced computer tomography (CT) was done subsequently. In the first patient, CT and magnetic resonance imaging (MRI) showed signs of pneumobilia, cholecystoduodenal fistula, and the presence of the gallstone in the stomach. The iodine contrast X-ray swallow test revealed a cholecysto-duodenal bulb fistula and floating calculus in the stomach, confirmed by endoscopy. In the second patient with persistent abdominal pain, CT and barium swallow test showed signs of pneumobilia, cholecystoduodenal fistula, and two ectopic gallstones obstructing duodenum ? Bouveret syndrome. The third case showed signs of the Rigler triad ? typical signs of gallstone ileus. Conclusion. Spontaneous cholecystoduodenal fistula is a rare condition with possible complications such as Bouveret syndrome, gallstone ileus and floating, non-obstructive gallstones in the stomach, as the rarest possible complication. CT, MRI with magnetic resonance cholangiopancreatography, as well as the contrast X-ray swallow test can be very helpful in the detection of the bilio-enteric fistula and ectopic gallstones.

Presentation of Gall Stone Ileus as Gut Obstruction

JMS SKIMS ◽  
2019 ◽  
Vol 21 (2) ◽  
pp. 117-119
Author(s):  
Munir Ahmad Wani ◽  
Mubarak Ahmad Shan ◽  
Syed Muzamil Andrabi ◽  
Ajaz Ahmad Malik
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Ct Scan ◽  
Bowel Obstruction ◽  
Emergency Surgery ◽  
Gallstone Ileus ◽  
Gall Stone ◽  
Life Threatening ◽  
Life Threatening Complication ◽  
Gall Stone Ileus

Gallstone ileus is an uncommon and often life-threatening complication of cholelithiasis. In this case report, we discuss a difficult diagnostic case of gallstone ileus presenting as small gut obstruction with ischemia. A 56-year-old female presented with abdominal pain and vomiting. A CT scan was performed and showed an evolving bowel obstruction with features of gut ischemia with pneumobilia although no frank hyper density suggestive of a gallstone was noted. The patient underwent emergency surgery and a 60 mm obstructing calculus was removed from the patient's jejunum, with a formal tube cholecystostomy. JMS 2018: 21 (2):117-119

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.

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 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 A Comparison of the Quality of Sleep between Pre and Post-Surgery Cervical Herniated Nucleus Pulposus Patients Utilizing the Anterior Discectomy Method

2017 ◽  
Vol 5 (7) ◽  
pp. 948-954
Author(s):  
Ridha Dharmajaya ◽  
Dina Keumala Sari ◽  
Ratna Akbari Ganie
Keyword(s):  
Sleep Quality ◽  
Nucleus Pulposus ◽  
Intervertebral Disk ◽  
Quality Of Sleep ◽  
Post Surgery ◽  
Anterior Discectomy ◽  
Significant Difference ◽  
Post Operation ◽  
Herniated Nucleus Pulposus

BACKGROUND: Herniated Nucleus Pulposus (HNP) is the prolapse of the intervertebral disk through a tear in the annulus fibrosus. This causes nerve root compression with clinical pain manifestation and affects the quality of sleep.AIM: The aim of this study was find out the comparison in the quality of sleep between before (pre) and after (post) surgery cervical HNP patients.METHODS: This study was a retrospective cohort study. Ninety patients were asked to complete the Pittsburgh Sleep Quality Index (PSQI) questionnaire. All data which has been computed were analysed with the McNemar test.RESULT: The outcome reveals that from 90 patient`s cervical HNP, 81 (90%) were 40 years old age group and 66 (73.3%) of them were women. The result showed that 66 (73.3%) patients have a bad sleep quality before surgery. Surgery has increased the quality of sleep after surgery 66 (73.3%) patients had good sleep quality. There was a significant difference in the quality of sleep pre and post operation (p = 0.001).CONCLUSION: There was a significant difference in the quality of sleep between pre and post operation cervical HNP patient utilising anterior discectomy methods.

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