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Case Series
Gallstone Ileus – A single center case series
1 MD, Resident, General Surgery Department, Hospital de Santa Lúzia, Viana do Castelo, Portugal
2 MD, Director, Department of Gastric Surgery, Hospital de Santa Lúzia, Viana do Castelo, Portugal
3 MD, Director, General Surgery Service in the Hospital de Santa Lúzia, Viana do Castelo, Portugal
Address correspondence to:
Manuel Alexandre Viana Ferreira
Rua António De Mariz, nº22, 4715-279 Braga,
Portugal
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Article ID: 100989Z01MF2019
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Ferreira MAV, Pinto D, Fazeres F, Midões A. Gallstone Ileus – A single center case series. Int J Case Rep Images 2019;10:100989Z01MF2019.ABSTRACT
Introduction: Gallstone ileus is a rare complication of cholelithiasis that accounts for 1−3% of mechanic ileus of the small bowel. It is characterized by bowel obstruction secondary to gallstone impaction that results from a migration due to the existence of a bilioenteric fistula. Gallstone Ileus is more common in the elderly with more comorbidities which leads to a high morbidity rate. Consequently, a debate exists regarding the appropriate surgical strategy for emergency treatment of gallstone ileus. The aim of the present study was to evaluate different surgical approaches based on the authors’ recent experience and to analyze the clinical outcome.
Case Series: Six patients were included, all females, with a mean age of 82 years. All patients had comorbidities, specially, cardiovascular diseases. Three of them had previous history of biliary pathology. Diagnosis was confirmed through computed tomography (CT) scan in five cases. The stone was in the ileum in three, jejunum in two, and duodenum in one patient; the mean stone size was 2.5 cm. Four patients were submitted proximal to enterotomy with the removal of the gallstone, one to gastrotomy and one to cholecystectomy and a cholecystoduodenal fistula closure. During the postoperative period, complications were recorded in three subjects, one patient died due to cerebrovascular accident.
Conclusion: The main key in guiding patients with gallstone ileus is the timely diagnosis which is currently facilitated with the support of the use of CT scan. Taking into consideration the age and comorbidities of these patients, the surgical management should be as conservative as possible.
Keywords: Bowel obstruction, Enterolithotomy, Gallstone ileus, Intestinal obstruction
SUPPORTING INFORMATION
Author Contributions
Manuel Alexandre Viana Ferreira - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Diogo Pinto - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Francisco Fazeres - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Alberto Midões - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this case series.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2019 Manuel Alexandre Viana Ferreira et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
