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Rigler triad in gallstone ileus

Lorena Brandariz Gil1, Tamara Fernández de Miguel2, José Perea3

  • 1Cirugía general y del Aparato Digestivo, Hospital Universitario 12 de Octubre, España.

Revista Espanola De Enfermedades Digestivas
|September 13, 2016
PubMed

Insights

Gallstone ileus, a rare biliary disease complication, causes intestinal obstruction via gallstones and bilio-digestive fistulas. Early diagnosis is crucial due to high mortality, often missed until surgery.

Area of Science:

  • Gastroenterology
  • Biliary Diseases
  • Surgical Complications

Background:

  • Gallstone ileus is an infrequent complication of biliary tract disease.
  • It involves intestinal obstruction resulting from a gallstone migrating through a bilio-digestive fistula.

Observation:

  • This condition is associated with significant morbidity and mortality.
  • Advanced patient age, comorbidities, and diagnostic delays are key contributing factors.
  • Diagnosis is frequently made postoperatively, highlighting the need for high clinical suspicion.

Findings:

  • Abdominal X-rays in gallstone ileus cases are often nonspecific.
  • The classic Rigler triad (pneumobilia, small bowel obstruction, and ectopic gallstone) is rarely observed in its entirety.

Implications:

  • Emphasizes the challenge in early clinical diagnosis of gallstone ileus.
  • Highlights the importance of considering rare complications in elderly patients with comorbidities.
  • Underscores the need for advanced imaging or diagnostic suspicion when typical signs are absent.

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