Gallstone ileus: the importance of 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.

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

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.

Clinical case of intussusception of the jejunum into gastroenteroanastomosis after gastric ­resection

Intussusception is one of the varieties of mixed (strangulation and obturation) mechanical intestinal obstruction. It arises as a result of the introduction of the adducting segment of the intestine into the abducting one. Gastroduodenal intussusception is an extremely rare type of high intestinal obstruction. It most often occurs after surgery on the stomach and much less often in non-operated patients. Intussusception of the jejunum into the stomach can occur soon after surgery, but most often, this complication occurs 515 years after the intervention. This paper describes a case of retrograde intussusception that arose 9 years after the Billroth II gastric resection with Braun anastomosis. This clinical case acquaints specialists with the possibility to encounter this pathology in clinical practice and demonstrates the appropriateness of differential diagnostics in cases with similar clinical symptoms.

A rare case of gallstone ileus—the unanswered question

Gallstone ileus is caused by an impaction of one or more gallstones within the gastrointestinal tract leading to mechanical intestinal obstruction. It is a rare complication of cholelithiasis and found in 2–3% of all cases associated with recurrent episodes of cholecystitis. This case study demonstrates an atypical presentation of gallstone ileus. A 57-year-old woman was presented with abdominal pain and vomiting without previous history of gallstone disease. The features of gallstone ileus are evident on computed tomography. She underwent an emergency laparotomy and enterotomy for the removal of impacting gallstones, followed by an interval cholecystectomy and cholecystoduodenal fistula closure. This case report aims to explore the proper surgical management of gallstone ileus. Unfortunately, the question of whether interval biliary surgery should be performed remains unanswered, and surgeons will continue to make the decision based on their clinical judgement.

Gallstone Ileus: A Rare Cause of Intraluminal Small Bowel Obstruction

Background: Gallstone ileus is mechanical intestinal obstruction secondary to impaction of a gallstone within the gastrointestinal tract, and accounts for 1-4% of mechanical bowel obstruction, with a preponderance in the female population [1]. Case Presentation: 56 year-old female presented with right upper quadrant pain (RUQ) and multiple vomits, current smoker. Mechanical obstruction noted on computerised-tomography and underwent laparotomy revealing gallstone ileus. This is on a background of two prior episodes of RUQ pain, presenting to the hospital but lost of follow-up after discharging against medical advice two years ago

Diagnosis and treatment of gallstone intestinal obstruction in an adult patient

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