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Postoperative Ileus Murine Model
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Acute intestinal obstruction due to gallstone ileus
Revista Do Colegio Brasileiro De Cirurgioes
|November 1, 2013
Summary
Gallstone ileus, a cause of small bowel obstruction (SBO) in the elderly, requires urgent laparotomy. Individualized surgical treatment, often enterolithotomy, can reduce complications and mortality.
Area of Science:
- Gastroenterology
- Surgical Gastroenterology
- Geriatric Medicine
Background:
- Gallstone ileus is a rare complication of gallstones, leading to small bowel obstruction (SBO).
- Diagnosis and management can be challenging, particularly in elderly patients with comorbidities.
Purpose of the Study:
- To systematically review the history, diagnostic imaging, and clinical management of gallstone ileus.
- To evaluate treatment outcomes based on surgical approach.
Main Methods:
- Retrospective study of SBO cases over 23 years.
- Patients divided into two groups: two-stage surgery (enterolithotomy then cholecystectomy) and one-stage surgery (enterolithotomy, cholecystectomy, fistula closure).
Main Results:
- Twelve patients (11 female, mean age 72.2 years) with gallstone ileus were identified.
- 50% of diagnoses were made pre-operatively.
- Morbidity was 33.3% for two-stage surgery vs. 8.3% for one-stage surgery. Overall mortality was 16.6%.
Conclusions:
- Gallstone ileus should be suspected in elderly patients presenting with SBO symptoms.
- Early diagnosis and individualized surgical management, prioritizing urgent laparotomy, are crucial.
- One-stage surgery demonstrated lower morbidity in this cohort.
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