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Gallstone ileus. Report of two cases
Erasmo Spaziani1, Marcello Picchio, Annalisa Di Filippo
1Department of Surgery, University of Rome "Sapienza", Polo Pontino, Terracina, Latina, Italy.
Annali Italiani Di Chirurgia
|July 3, 2010
Summary
Gallstone ileus, a rare condition, involves gallstones blocking the small intestine. This report details two jejunal impaction cases, highlighting diagnostic and treatment approaches for this uncommon gastrointestinal obstruction.
Area of Science:
- Gastroenterology
- Abdominal Surgery
- Radiology
Background:
- Gallstone ileus is an infrequent complication of gallstones.
- Small bowel obstruction due to gallstone impaction, particularly in the jejunum, is rarely documented.
Observation:
- This report presents two distinct cases of gallstone impaction.
- One case involved the proximal jejunum, while the other affected the distal ileum.
- Diagnostic imaging relied on contrast-enhanced computed tomography (CECT) of the abdomen.
Findings:
- Treatment strategies varied based on case complexity.
- One patient underwent enterolithotomy alone for gallstone removal.
- The second patient required a combined approach: enterolithotomy, cholecystectomy, and repair of a cholecystoduodenal fistula.
Implications:
- Contrast-enhanced computed tomography (CECT) is crucial for diagnosing gallstone ileus.
- A one-stage surgical procedure (enterolithotomy, cholecystectomy, fistula repair) is suitable for low-risk patients.
- Careful patient selection is essential for managing complex gallstone ileus cases.
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