Display options
Cite
Conzo G, Mauriello C, Gambardella C, et al. Gallstone ileus: One-stage surgery in an elderly patient: One-stage surgery in gallstone ileus. Int J Surg Case Rep. 2013;4(3):316-8doi: 10.1016/j.ijscr.2012.12.016.
Conzo, G., Mauriello, C., Gambardella, C., Napolitano, S., Cavallo, F., Tartaglia, E., & Santini, L. (2013). Gallstone ileus: One-stage surgery in an elderly patient: One-stage surgery in gallstone ileus. International journal of surgery case reports, 4(3), 316-8. https://doi.org/10.1016/j.ijscr.2012.12.016
Conzo, G, et al. "Gallstone ileus: One-stage surgery in an elderly patient: One-stage surgery in gallstone ileus." International journal of surgery case reports vol. 4,3 (2013): 316-8. doi: https://doi.org/10.1016/j.ijscr.2012.12.016
Conzo G, Mauriello C, Gambardella C, Napolitano S, Cavallo F, Tartaglia E, Santini L. Gallstone ileus: One-stage surgery in an elderly patient: One-stage surgery in gallstone ileus. Int J Surg Case Rep. 2013;4(3):316-8. doi: 10.1016/j.ijscr.2012.12.016. Epub 2013 Jan 19. PMID: 23396396; PMCID: PMC3604665.
Copy Download .nbib Format: NLM
Share it on

Int J Surg Case Rep. 2013;4(3):316-8. doi: 10.1016/j.ijscr.2012.12.016. Epub 2013 Jan 19.

Gallstone ileus: One-stage surgery in an elderly patient: One-stage surgery in gallstone ileus.

International journal of surgery case reports

G Conzo, C Mauriello, C Gambardella, S Napolitano, F Cavallo, E Tartaglia, L Santini

Affiliations

  1. Department of Anaestesiologic, Surgical and Emergency Science, VII Division of General Surgery, Second University of Naples, Via Pansini 5, 80131 Naples, Italy. Electronic address: [email protected].

PMID: 23396396 PMCID: PMC3604665 DOI: 10.1016/j.ijscr.2012.12.016

Abstract

INTRODUCTION: Gallstone ileus (G.I.) is a mechanical bowel obstruction due to impaction of a large gallstone within the bowel and represents an uncommon complication of cholelithiasis. It accounts for 1-4% of all cases of mechanical bowel obstruction, up to 25% in patients over 65 years of age.

PRESENTATION OF CASE: A 75 year old male patient was referred to our hospital in March 2009 with clinical signs of bowel obstruction (abdominal pain and distension, post-prandial vomiting, absolute constipation) during the previous 3 days. A plain abdominal film demonstrated dilated bowel loops, air fluid levels and an image of a stone in the inferior left quadrant. Afterwards, diagnosis of Gallstone ileus was made by means of ultrasonography and colonoscopy. The patient underwent emergent laparotomy and a cholecysto-transverse colon fistula was observed. One-stage procedure consisting of enterolithotomy, cholecystectomy and fistula repair was performed. The post-operative course was complicated by a dehiscence of the colic suture with acute peritonitis. Therefore a colostomy was performed, followed by rapid recovery of general clinical conditions.

DISCUSSION: Surgical treatment for G.I. by cholecysto-enteric fistula is still controversial. Enterolithotomy alone is best suited in all elderly patients with significant comorbidities. One-stage procedure - enterolithotomy, cholecystectomy and fistula repair - should be reserved for young, fit and low risk patients. In our case, mechanical obstruction was associated with a severe cholecystitis with a large fistula between gallbladder and transverse colon.

CONCLUSION: A "radical" surgical option could certainly be characterized by a significant morbidity.

Copyright © 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

References

  1. Rev Esp Enferm Dig. 2011 May;103(5):277-8 - PubMed
  2. Gastrointest Endosc. 2011 Jul;74(1):228-30 - PubMed
  3. Gastroenterol Hepatol. 2001 Dec;24(10):489-94 - PubMed
  4. Surg Laparosc Endosc Percutan Tech. 2003 Apr;13(2):83-7 - PubMed
  5. Hepatogastroenterology. 1992 Dec;39(6):562-5 - PubMed
  6. Ugeskr Laeger. 2011 Dec 12;173(50):3275 - PubMed
  7. Eur J Radiol. 2004 Apr;50(1):23-9 - PubMed
  8. Br J Surg. 2007 Jan;94(1):53-7 - PubMed
  9. Endoscopy. 2006 Feb;38(2):197 - PubMed
  10. Abdom Imaging. 2001 Jul-Aug;26(4):401-5 - PubMed
  11. Am J Surg. 1980 Sep;140(3):437-40 - PubMed
  12. Ann Surg. 1966 Dec;164(6):1051-5 - PubMed
  13. Intern Med J. 2011 Sep;41(9):705-6 - PubMed
  14. Surg Gynecol Obstet. 1981 Oct;153(4):527-31 - PubMed
  15. World J Surg. 2003 Apr;27(4):400-4 - PubMed
  16. Br J Surg. 1990 Jul;77(7):737-42 - PubMed
  17. Am J Gastroenterol. 2002 Feb;97(2):249-54 - PubMed

Publication Types