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[Gallstone ileus--the diagnostic and surgical problems]
Khirurgiia
|January 1, 1989
Summary
Biliary-calculus ileus, a complication of gallstones, presents diagnostic and surgical challenges. Management prioritizes treating the ileus complication, with underlying gallstone disease treatment depending on patient factors.
Area of Science:
- Gastroenterology
- Surgical Pathology
- Hepatobiliary Surgery
Background:
- Biliary-calculus ileus (Bcalculus ileus) is a rare complication of gallstones.
- It involves gallstones obstructing the small intestine, leading to ileus.
- Diagnosis and surgical management pose significant challenges.
Observation:
- Three cases of biliary-calculus ileus in elderly women (mean age 68) with a history of gallstones and comorbidities are presented.
- Patients had long-standing biliary calculosis and associated diseases.
Findings:
- Clinical manifestations, diagnostic approaches, and operative challenges of biliary-calculus ileus are analyzed.
- Unresolved issues in operative management of both the ileus complication and the underlying gallstone disease (cholelithiasis and biliodigestive fistula) are discussed.
Implications:
- Surgical management should first address the ileus complication.
- Treatment of the underlying gallstone disease is individualized based on ileus severity, patient age, local findings, hepatobiliary status, and comorbidities.