Toral-Chan AI, Palacios-Padrón A, Vázquez-Hernández R

Language: Spanish
References: 12
Page: 92-95
PDF size: 176.27 Kb.

ABSTRACT

Gallstone ileus is defined as a mechanical obstruction of the gastrointestinal tract caused by the presence of a gallstone in its lumen. It accounts for 1-3% cases of small intestinal obstruction. Up to 25% of all cases are seen in patients older than 65 years. Mortality reported ranges from 12 a 27% particularly in older patient who often have comorbid illnesses. The aim of this case report is communicate the importance of prompt diagnosis and surgical management of gallstone ileus. Clinical case: A 52 years old female presented at the emergency department with abdominal pain. The pain was located in the right hypochondrium, colicky in nature and radiated to the back. The patient complained of nausea, vomiting and constipation. On clinical examination we observed distended abdomen with tenderness, guarding and reduced bowel sounds. On rectal examination, there was no stool. Laboratory tests revealed discrete leukocytosis. CT reported cholecystoduodenal fistula, pneumobilia and the presence of gallstone in terminal ileum. The patient was diagnosed and treated successfully performing a one-stage operation. Conclusion: Gallstone ileus is a difficult clinical entity to diagnose and therefore requires a high index of suspicion. Treatment must be individualized especially in patients with a high risk of complications.

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