Gallstone ileus treated with non-surgical conservative methods: a case report

Area of Science:

• Gastroenterology
• Surgical Innovation
• Medical Imaging

Background:

• Gallstone ileus presents variably, complicating preoperative diagnosis and often leading to delayed treatment.
• While surgery is standard, less invasive methods for gallstone ileus management are increasingly explored.
• This report details an unusual case of gallstone ileus managed conservatively.

Observation:

• A 49-year-old woman presented with bowel sub-occlusion, diagnosed via X-ray and CT scan as gallstone ileus.
• Conservative treatment included extracorporeal shock-wave lithotripsy, mechanical intestinal dilatation, and endoscopic gallstone removal.
• An apricot shell was also identified and removed, contributing to the obstruction.

Findings:

• The conservative management strategy was successful, with no complications reported.
• Colonoscopy proved to be a valuable tool for both diagnosing and treating gallstone ileus non-invasively.
• The patient's treatment involved fragmentation of stones, dilatation of stenosis, and endoscopic removal.

Implications:

• Conservative management, including colonoscopy, can be an effective alternative to surgery for select gallstone ileus patients.
• This approach offers a less invasive option with no apparent increase in recurrent biliary disease.
• The case highlights the potential for non-surgical interventions in challenging gallstone ileus presentations.