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[Gallstone ileus. A report of 104 cases]
J Hildebrandt1, U Herrmann, H Diettrich
1Klinik für Chirurgie, Medizinischen Akademie Carl Gustav Carus, Dresden.
Summary
Gallstone ileus, a rare intestinal obstruction caused by gallstones, requires immediate relief of blockage. Management focuses on obstruction, not gallstones, leading to reduced mortality.
Area of Science:
- Gastroenterology
- Abdominal Surgery
Background:
- Gallstone ileus occurs when gallstones obstruct the small intestine, often via a biliodigestive fistula.
- It presents with varied clinical symptoms and can manifest in peritonitical, remittent, or obturation forms.
Purpose of the Study:
- To analyze cases of gallstone ileus, focusing on its presentation, diagnosis, and management.
- To evaluate the effectiveness of current management strategies and their impact on mortality.
Main Methods:
- Retrospective analysis of 104 gallstone ileus cases in 102 patients.
- Review of clinical symptoms, diagnostic findings (including roentgenological), and treatment outcomes.
Main Results:
- Biliary stones reached the intestinal tract via fistula in 80-85% of cases.
- Roentgenological findings included aerobilia (36%), radiopaque stones (8%), and obstruction signs (97%).
- Mortality decreased from 40-50% to 25% over the study period.
Conclusions:
- Relieving intestinal obstruction is the primary goal in managing gallstone ileus.
- Prompt surgical intervention focused on the obstruction significantly improves patient outcomes and reduces mortality.