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[Ultrasonographic diagnosis of a biliary-digestive fistula with gallstone ileus]
History And Clinical Findings:
A 72-year-old woman was admitted to the hospital with upper abdominal pain, nausea, vomiting, and obstipation.
Investigations:
Percutaneous ultrasound found aerobilia, a biliary-digestive fistula, and an ileus with gallstones within the small bowel. The findings were confirmed at computed tomography.
Treatment And Course:
A gallstone ileus on the basis of a biliary-digestive fistula was diagnosed. The patient was treated by surgery and with antibiotics.
Conclusion:
This case report demonstrates that percutaneous ultrasonography should be used as the first imaging procedure in the diagnosis of acute abdominal pain. This procedure makes it possible to detect a gallstone ileus. It is important also to define various intestinal structures accurately.
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