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Gallstone ileus--clinical and therapeutic aspects
M Beuran1, I Ivanov, M D Venter
1Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
Journal of Medicine and Life
|January 25, 2011
Summary
Gallstone ileus, a rare complication of gallbladder disease, often affects older women and is frequently misdiagnosed preoperatively. Modern endoscopic and laparoscopic treatments are improving outcomes for this serious condition.
Area of Science:
- Gastroenterology
- Abdominal Surgery
Background:
- Gallstone ileus is a rare but serious complication of gallbladder lithiasis.
- Its incidence remains stable, disproportionately affecting females over 65.
Purpose of the Study:
- To review the pathogenesis of gallstone ileus.
- To discuss diagnostic challenges and modern treatment modalities.
- To highlight factors contributing to high mortality rates.
Main Methods:
- Literature review of gallstone ileus pathogenesis.
- Analysis of diagnostic criteria, including the Rigler triad on CT scans.
- Description of evolving treatment strategies: endoscopic and laparoscopic approaches.
Main Results:
- Preoperative diagnosis is established in less than 50% of cases, with a 25% misdiagnosis rate due to underestimating gallstone size.
- Recurrence rates range from 4.7-5%.
- High mortality persists, primarily due to comorbidities and delayed presentation.
Conclusions:
- Gallstone ileus requires careful diagnosis, often challenging due to imaging limitations.
- Minimally invasive techniques offer improved treatment options.
- Addressing comorbidities and promoting early detection are crucial to reduce mortality.
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