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Carr SP, MacNamara FT, Muhammed KM, et al. Perforated closed-loop obstruction secondary to gallstone ileus of the transverse colon: a rare entity. Case Rep Surg. 2015;2015:691713doi: 10.1155/2015/691713.
Carr, S. P., MacNamara, F. T., Muhammed, K. M., Boyle, E., McHugh, S. M., Naughton, P., & Leahy, A. (2015). Perforated closed-loop obstruction secondary to gallstone ileus of the transverse colon: a rare entity. Case reports in surgery, 2015691713. https://doi.org/10.1155/2015/691713
Carr, S P, et al. "Perforated closed-loop obstruction secondary to gallstone ileus of the transverse colon: a rare entity." Case reports in surgery vol. 2015 (2015): 691713. doi: https://doi.org/10.1155/2015/691713
Carr SP, MacNamara FT, Muhammed KM, Boyle E, McHugh SM, Naughton P, Leahy A. Perforated closed-loop obstruction secondary to gallstone ileus of the transverse colon: a rare entity. Case Rep Surg. 2015;2015:691713. doi: 10.1155/2015/691713. Epub 2015 Feb 05. PMID: 25722913; PMCID: PMC4334423.
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Case Rep Surg. 2015;2015:691713. doi: 10.1155/2015/691713. Epub 2015 Feb 05.

Perforated closed-loop obstruction secondary to gallstone ileus of the transverse colon: a rare entity.

Case reports in surgery

S P Carr, F T MacNamara, K M Muhammed, E Boyle, S M McHugh, P Naughton, A Leahy

Affiliations

  1. Royal College of Surgeons in Ireland, Dublin 2, Ireland.
  2. Royal College of Surgeons in Ireland, Dublin 2, Ireland ; Department of Surgery, Beaumont Hospital, Dublin 17, Ireland.
  3. Department of Surgery, Beaumont Hospital, Dublin 17, Ireland.

PMID: 25722913 PMCID: PMC4334423 DOI: 10.1155/2015/691713

Abstract

Introduction. Gallstone ileus (GSI) of the colon is an extremely rare entity with potentially serious complications including perforation. Case Presentation. An 88-year-old man presented to the emergency department with abdominal pain and distension. Clinical exam revealed signs of peritonism. Computed tomography (CT) revealed GSI of the transverse colon with a closed-loop large bowel obstruction (LBO) and caecal perforation. The patient underwent emergency laparotomy. A right hemicolectomy was performed, the gallstone was removed, and a primary bowel anastomosis was undertaken. A Foley catheter was sutured into the residual gallbladder bed to create a controlled biliary fistula. The patient recovered well postoperatively with no complications. He was discharged home with the Foley catheter in situ. Discussion. Gallstone ileus is a difficult diagnosis both clinically and radiologically with only 50% of cases being diagnosed preoperatively. Most commonly it is associated with impaction at the ileocaecal valve and small bowel obstruction. Gallstone ileus should also be considered as a rare but potential cause of LBO. This is the first reported case of caecal perforation secondary to gallstone ileus of the transverse colon. Successful operative management consisted of a one-stage procedure with right hemicolectomy and formation of a controlled biliary fistula.

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