scholarly journals Gallstone Ileus: Clinical Presentation of a Benign Mechanical Intestinal Obstruction

2008 ◽  
Vol 2 (1) ◽  
pp. 144-148 ◽  
Author(s):  
Eduardo E. Montalvo-Jave ◽  
Eduardo Alegre-Tamez ◽  
César Athie-Gutiérrez
Keyword(s):  
Intestinal Obstruction ◽  
Clinical Presentation ◽  
Gallstone Ileus ◽  
Mechanical Intestinal Obstruction

scholarly journals New in the problem gallstone bowel obstruction

2020 ◽  
Vol 25 (1) ◽  
pp. 62-68
Author(s):  
V. I. Mamchich ◽  
N. D. Bondarenko ◽  
M. A. Chaika
Keyword(s):  
Intestinal Obstruction ◽  
Gallstone Ileus ◽  
Bile Leakage ◽  
Acute Intestinal Obstruction ◽  
Diagnostic Methods ◽  
Acute Calculous Cholecystitis ◽  
Topical Diagnosis ◽  
Mechanical Intestinal Obstruction ◽  
Complex Forms ◽  
Calculous Cholecystitis

Aim. To identify the frequency of gallstone ileus based on the surgical experience of the Kiev region in patients with acute calculous cholecystitis and acute intestinal obstruction. To evaluate the capabilities of the gallstone ileus diagnosis algorithm for correct topical diagnosis before surgery.Materials and methods. For 2004–2018, 13713 patients with acute cholecystitis and 3609 patients with acute intestinal obstruction were hospitalized. In 0.64% of cases, gallstone ileus was diagnosed in patients with acute calculous cholecystitis, in 0.41% in choledocholithiasis, and in 2.4% in its complex forms. In 0.73% gallstone ileus was detected during operations for acute intestinal obstruction and in 1.12% for its obstructive form.Results. A total of 25 patients with gallstone intestinal obstruction underwent surgery. In the topical diagnosis of gallstone intestinal obstruction, X-ray contrast methods dominate. During surgical procedure, only with pyloroduodenal variants of obstruction, cholecystectomy is performed simultaneously with the elimination of obstruction. In other situations, cholecystectomy is performed after 3–8 months. Of the 25 patients, 4 patients died due to ascending cholangitis, peritonitis due to bile leakage, and severe co-morbidities.Conclusion. The use of the algorithm of advanced diagnostic methods allows you to receive a diagnosis in most patients. The most valuable in topical diagnostics are contrast methods. New in gallstone ileus is the migration of gallstone after endoscopic papillosphincterotomy with mechanical lithotripsy for choledocholithiasis, especially with its complex forms. In our opinion, all types of gallstone ileus can be combined into Bartolin-Bouveret syndrome, which first described this variant of mechanical intestinal obstruction.

scholarly journals Gallstone ileus as a cause of upper intestinal obstruction

1996 ◽  
Vol 114 (4) ◽  
pp. 1239-1243 ◽  
Author(s):  
Israel Szajnbock ◽  
Fernando Lorenzi ◽  
Aldo Junqueira Rodrigues Jr. ◽  
Luis Fernando Correa Zantut ◽  
Renato Sérgio Poggetti ◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
Surgical Approach ◽  
Gallstone Ileus ◽  
Age Groups ◽  
Ileocecal Valve ◽  
Older Age ◽  
Intestinal Lumen ◽  
Degenerative Diseases ◽  
Two Stage ◽  
Mechanical Intestinal Obstruction

Gallstone ileus, a mechanical intestinal obstruction caused by the passage of a gallstone into the intestinal lumen through a fistula, although not common, deserves to more carefully studied due to its morbidity and mortality. Its incidence among older-age groups explains its association with chronic and degenerative diseases, which increase the complexity of the treatment choice.The need and appropriateness of a surgical approach to a cholecystenteric fistula to solve the obstructive emergency, in a one or two stage procedure, has been discussed in the literature. It has also been reported that gallstone ileus is an uncommon cause of upper intestinal obstruction. Intestinal obstruction is seen more frequently after a gallstone impacts at the ileocecal valve. The authors report a case of gallstone ileus as a cause of upper intestinal obstruction and discuss its diagnosis and treatment.

scholarly journals Gallstone ileus: dilemma in the management

2017 ◽  
Vol 7 (3) ◽  
Author(s):  
Girish D. Bakhshi ◽  
Rajesh G. Chincholkar ◽  
Jasmine R. Agarwal ◽  
Madhukar R. Gupta ◽  
Prachiti S. Gokhe ◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
Gallstone Ileus ◽  
Postoperative Recovery ◽  
Duodenal Fistula ◽  
Respiratory Complications ◽  
One Stage ◽  
Mechanical Intestinal Obstruction ◽  
To Come ◽  
Definitive Management ◽  
The Ideal

Gallstone ileus is a mechanical intestinal obstruction caused due to impaction of a large gallstone within the bowel. The ideal treatment of gallstone ileus remains controversial, with the main dilemma being between a one-stage and a two-stage surgical procedure. A 69-year old male patient presented with gallstone ileus. A one-stage procedure with enterolithotomy and primary closure of duodenal fistula was done. His immediate postoperative recovery was uneventful, but after 3 weeks of surgery, he developed respiratory complications and expired of multi-organ failure. In gallstone ileus, patient presents with symptoms of intestinal obstruction. Enterolithotomy alone remains the most common operative method, but the definitive surgical management is still under research. An intraoperative dilemma between a one-stage or twostage surgery is difficult to resolve in absence of clear guidelines. Hence, more studies are required to come to a consensus in deciding its definitive management.

scholarly journals Diagnosis and treatment of gallstone intestinal obstruction in an adult patient

2021 ◽  
Vol 9 (2) ◽  
pp. 090-094
Author(s):  
Fatin R. Polat ◽  
Ilhan Bali ◽  
Yasin Duran ◽  
Suat Benek
Keyword(s):  
Intestinal Obstruction ◽  
Gallstone Ileus ◽  
Biliary Colic ◽  
Two Stage ◽  
Abdominal Ct ◽  
Case Presentation ◽  
Mechanical Intestinal Obstruction ◽  
History Of ◽  
Surgery First ◽  
Bowel Dilatation

Background: Gallstone ileus, which is called Type Vb Mirizzi Syndrome, is a rare case of mechanical intestinal obstruction observed in older patients with history of cholelithiasis or cholecystitis. Diagnostic Imaging plays an important role in the management of patients with suspected gallstone ileus. X-Ray and Abdominal Computed Tomography (CT) are the preferred modality. Case presentation: The patient was diagnosed with gallstone ileus at the age of 45. The case had 10 years history of biliary colic disease. The patient who is suffered from intestinal obstruction. CT demonstrated pneumobilia involving the gallbladder, a 5, 5 cm calcified stone in the ileum and small bowel dilatation. He underwent enterolithotomy and a huge stone was removed. When gallbladder area was checked, the gallbladder was highly adherent (to colon and stomach) and was inflamed. We suspected malignancy so multipl biopsy was taken. Two-stage treatment model was planned. After the surgery, any emerging complications were closely monitored. Conclusions: Abdominal CT are the preferred modality for diagnosis. The main treatment for gallstone intestinal obstruction is surgery. First step enterotomy, later intented for the gallbladder. There are two type of surgical approach for gallbladder: one-stage treatment or two-stage treatment according the inflammation of gallbladder

scholarly journals Gallstone ileus: the importance of individualized management

2021 ◽  
Vol 8 (8) ◽  
pp. 2432
Author(s):  
Soulé-Martínez Christian Enrique ◽  
Alfaro-Ponce David ◽  
Castellanos-Aguilar Leonel ◽  
Jaimes-Durán Edwing Michel ◽  
Banegas-Ruíz Rodrigo ◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
Gallstone Ileus ◽  
Surgical Techniques ◽  
Exploratory Laparotomy ◽  
Stone Extraction ◽  
Distal Intestine ◽  
Mechanical Intestinal Obstruction ◽  
Bilioenteric Fistula ◽  
The One ◽  
Individualized Management

Gallstone ileus represents a complication of cholelithiasis, which in the literature has been reported as a rare cause of mechanical intestinal obstruction, however, the reported incidence is not so low, especially after 65 years of age. The formation of a bilioenteric fistula allows the passage of a large gallstone into the intestine, usually impacting the distal intestine. It is associated with a mortality that ranges between 12 and 27%. Treatment is surgical, although there is no consensus on which of the surgical techniques is the one of choice. We report the case of an 87-year-old male patient who was admitted to the emergency department with intestinal obstruction. He was diagnosed with gallstone ileus and was treated surgically with exploratory laparotomy, enterotomy with stone extraction, and primary closure. The evolution was favorable and without complications.

scholarly journals Investigating a rare cause of intestinal occlusion

2017 ◽  
Vol 13 (1) ◽  
Author(s):  
Bahjat Barakat ◽  
Raffaele Pezzilli
Keyword(s):  
Early Diagnosis ◽  
Physical Examination ◽  
Intestinal Obstruction ◽  
Rare Case ◽  
Gallstone Ileus ◽  
Rare Entity ◽  
Rare Form ◽  
Emergency Situations ◽  
Gastrointestinal Obstruction ◽  
Mechanical Intestinal Obstruction

Gallstone ileus is a rare form of mechanical intestinal obstruction caused by the passage of gallstones in the gastrointestinal lumen and is often diagnosed in elderly females. Diagnosis can be difficult due to nonspecific findings during physical examination and there are a number of options regarding surgical or endoscopic treatment. We report the rare case of a 77- year-old female patient with gastrointestinal obstruction due to a gallstone, but without a cholecystointestinal fistula. Clinicians should be aware of this rare entity especially in emergency situations, as early diagnosis and appropriate subsequent therapy in such cases is essential to reduce mortality.

CHANGES IN SMALL INTESTINE MICROFLORA IN PATIENTS WITH ACUTE INTESTINAL OBSTRUCTION

2020 ◽  
pp. 16-18
Author(s):  
V. M. Lykhman ◽  
O. M. Shevchenko ◽  
Ye. O. Bilodid ◽  
Igor Vladimirovich Volchenko ◽  
I. A. Kulyk ◽  
...  
Keyword(s):  
Small Intestine ◽  
Gastrointestinal Tract ◽  
Species Composition ◽  
Intestinal Obstruction ◽  
Bacterial Flora ◽  
Anaerobic Bacteria ◽  
Acute Intestinal Obstruction ◽  
Gram Positive ◽  
Mechanical Intestinal Obstruction ◽  
Facultative Anaerobic Bacteria

Among urgent surgical diseases of abdominal cavity, an acute intestinal obstruction is the most difficult to be diagnosed and treated. Leading factor, determining the development of pathophysiological processes is considered to be the progressive manifestations of enteric insufficiency syndrome, resulting in intestinal barrier impairment, negative changes in ecology of intestinal flora, increased endotoxins. To identify the small intestine microflora in acute intestinal obstruction and determine the role of dysbiotic disorders in clinical manifestations of main pathological process, a study was conducted in 60 patients with mechanical intestinal obstruction. The small intestine has a relatively rare microflora, consisting mainly of gram−positive facultative aerobic microorganisms, streptococci, lactobacilli. The distal ileum in nearly 30−55 % of healthy people contains scanty microflora, and yet the flora of this area differs from the microbial population of the higher gastrointestinal tract due to higher concentration of gram−negative bacteria. Optional−anaerobic coliform bacilli, anaerobic bifidobacteria and fusobacteria, bacteroids, the number of which starts exceeding the one of gram−positive species, are presented in significant quantities. Distal to the ileocecal valve there are significant changes in the microflora quantitative and species composition. Obligatory anaerobic bacteria become the predominant part of microflora, exceeding the number of aerobic and facultative anaerobic bacteria. The bacterial flora in different parts of gastrointestinal tract has its own specifics and is quite constant, as a result of the interaction of many factors, regulating the bacterial population in small intestine. The most important among them are: acidity of gastric juice, normal peristaltic activity of the intestine, bacterial interactions and immune mechanisms. Disorders of the intestine motor and evacuation function with its obstruction lead to slow passage of the chyme and contamination of the upper gastrointestinal tract with new types of microbes. There is a syndrome of small intestine excessive colonization, which means an increased concentration of bacterial populations in it, similar in species composition to the colon microflora. Pathological intra−intestinal contents become a source of endogenous infection and re−infection of the patient, leads to internal digestive disorders, which is manifested by syndrome of malabsorption of proteins, carbohydrates and vitamins. Key words: acute intestinal obstruction, small intestinal microflora, conditionally pathogenic microorganisms, intestinal biocenosis.

A Rare Cause of Mechanical Intestinal Obstruction: A Neoplastic Intra-Abdominal Testis

2016 ◽  
Vol 101 (3-4) ◽  
pp. 167-170
Author(s):  
Fatih Ciftci ◽  
Suat Benek ◽  
Cem Kezer
Keyword(s):  
Intestinal Obstruction ◽  
Acute Abdomen ◽  
Undescended Testis ◽  
Abdominal Mass ◽  
Relevant Literature ◽  
Large Diameter ◽  
Exploratory Laparotomy ◽  
Clinical Findings ◽  
Surgical Units ◽  
Mechanical Intestinal Obstruction

The acute abdomen has many etiologies frequently encountered in emergency surgical units. Approximately 20% of surgical admissions for acute abdominal conditions are for intestinal obstruction. Clinicians often overlook rarer causes. A 43-year-old man presented to the emergency ward with the clinical findings of ileus. Computed tomography revealed a heterogeneous necrotic 168 × 100-mm mass between the sigmoid colon and urinary bladder. Physical examination revealed a palpable intra-abdominal mass that was removed via exploratory laparotomy. On histopathologic examination, the mass was identified as a seminoma. The literature contains few reports of seminoma as a cause of acute abdomen and ileus, mostly seen between the ages of 30 and 40 years. We report a patient with seminoma arising in an undescended testis that presented as a palpable painful lower abdominal mass and mechanical intestinal obstruction, despite the large diameter of the mass, as well as review relevant literature.

scholarly journals Ileoileal knotting: a rare cause of intestinal obstruction: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Yusuf Mohammed ◽  
Kirubel Tesfaye
Keyword(s):  
Abdominal Pain ◽  
Intestinal Obstruction ◽  
Sudden Onset ◽  
Rapid Progression ◽  
Case Presentation ◽  
Postoperative Course ◽  
Child Bearing ◽  
Mechanical Intestinal Obstruction ◽  
Tentative Diagnosis ◽  
Very High

Abstract Background Ileoileal knotting is one of the rarest causes of intestinal obstruction. The pathology involves knotting of the ileum around itself, leading to mechanical intestinal obstruction that can rapidly evolve to gangrene. Case presentation Here we will discuss the case of an 18-year-old Oromo girl who presented with sudden onset of severe abdominal pain and signs of generalized peritonitis.Ultrasound examination showed massive peritoneal and cul-de-sac fluid. Explorative laparotomy was done, with a tentative diagnosis of ruptured ovarian cyst. Intraoperative finding was a gangrenous ileoileal knot. The gangrenous segment was resected and ileotransverse anastomosis done. Postoperative course was uneventful, and the patient was discharged improved on the sixth postoperative day. Conclusion We present this case to highlight the diagnostic difficulty that one can face in females of child-bearing age and to create awareness of this rare cause of intestinal obstruction, as morbidity and mortality are very high because of rapid progression to gangrene.

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