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Colonic perforation by a large gallstone: A rare case report
Devin R Halleran1, David R Halleran1
1College of Medicine Upstate Medical University, Syracuse, NY 13210, United States.
International Journal of Surgery Case Reports
|December 16, 2014
Summary
Gallstone perforation of the sigmoid colon is rare. This case highlights the need for prompt surgical intervention when conservative management fails for impacted gallstones in the colon.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Abdominal Imaging
Background:
- Gallstone ileus is a rare cause of bowel obstruction.
- This case presents a gallstone perforating the sigmoid colon in an 86-year-old woman.
Purpose of the Study:
- To report a case of sigmoid colon perforation due to a gallstone.
- To emphasize the importance of timely surgical intervention for impacted colonic gallstones.
Main Methods:
- A case study of an 86-year-old woman with abdominal pain and nausea.
- Diagnostic imaging including X-ray and CT scan revealed a gallstone in the sigmoid colon.
- Failed conservative and endoscopic management led to exploratory laparotomy and Hartmann's procedure.
Main Results:
- A 3.5cm gallstone was found impacted in the sigmoid colon.
- The patient underwent a Hartmann's procedure due to perforation.
- The patient experienced a complicated post-operative recovery.
Conclusions:
- Gallstone obstruction in the colon is uncommon but requires prompt identification and management.
- Conservative measures for colonic gallstones should be attempted, but failure warrants suspicion of stricture and consideration for earlier surgical intervention.
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