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Colonic gallstone ileus: the rolling stones
1Department of Surgery, Mater Misericordiae University Hospital, Dublin, Ireland.
BMJ Case Reports
|October 18, 2014
Summary
Gallstone ileus, a rare cause of bowel obstruction in the elderly, can be effectively treated with minimally invasive laparoscopic surgery. This approach offers a swift recovery for patients with impacted gallstones in the colon.
Area of Science:
- Gastroenterology
- Surgical Oncology
Background:
- Gallstone ileus is a rare complication of gallstones (cholelithiasis), causing intestinal obstruction in 1-4% of cases.
- It predominantly affects the elderly and presents insidiously, leading to high morbidity and mortality rates.
Observation:
- An 85-year-old woman presented with symptoms of large bowel obstruction.
- Radiological imaging revealed a large gallstone (5 cm x 3.5 cm) obstructing the sigmoid colon.
Findings:
- A laparoscopic-assisted enterolithotomy successfully removed the gallstone and relieved the obstruction.
- This minimally invasive approach resulted in a swift and uneventful recovery.
Implications:
- Highlights the importance of a high index of suspicion for diagnosing gallstone ileus.
- Demonstrates the advantages of laparoscopic surgery for emergency management of gallstone ileus, reducing surgical insult.
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