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Gallstone ileus in Caroli's disease.

S Gaiani¹, C Serra, M Cervellera

¹Dipartimento di Medicina Interna e Gastroenterologia, Università degli Studi di Bologna, Italy.

The American Journal of Gastroenterology

|January 11, 2001

Summary

Gallstone ileus complicated Caroli's disease type II, suspected clinically and diagnosed via ultrasound. This imaging modality is valuable for diagnosing bowel obstruction and identifying its cause.

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Area of Science:

Hepatobiliary disease
Gastrointestinal complications
Medical imaging

Background:

Caroli's disease is a rare congenital disorder characterized by cystic dilatation of the intrahepatic bile ducts.
Type II Caroli's disease involves diffuse saccular dilatation of the intrahepatic bile ducts.
Gallstone ileus is a rare complication of cholelithiasis where a gallstone erodes through the gallbladder wall into the gastrointestinal tract, causing obstruction.

Observation:

A patient with type II Caroli's disease developed gallstone ileus.
Previous hepaticojejunostomy surgeries were implicated in facilitating gallstone migration into the bowel.
Clinical suspicion of gallstone ileus was high based on patient history.

Findings:

Ultrasound examination successfully diagnosed gallstone ileus.

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Plain abdominal X-ray did not reveal aberrantly located stones.

Ultrasound confirmed bowel obstruction, assessed its level, and identified the cause.

Implications:

Ultrasound is a crucial tool in diagnosing bowel obstruction, especially in complex cases like Caroli's disease.
Early diagnosis of gallstone ileus can lead to timely intervention and improved patient outcomes.
This case highlights a rare but serious complication associated with Caroli's disease and prior biliary surgeries.