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Gallstone ileus presenting as intussusception: A case report.

Rahul M Prasad1, Katrina M Weimer1, Arunkumar Baskara1

  • 1The University of Toledo College of Medicine and Life Sciences, 3000 Arlington Ave, Toledo, OH 43614, USA.

International Journal of Surgery Case Reports
|November 30, 2016
PubMed
Summary
This summary is machine-generated.

Gallstone ileus, a rare cause of small bowel obstruction (SBO) in the elderly, can mimic intussusception. Surgical intervention via enterolithotomy successfully treated a patient with prior cholecystectomy, highlighting the need for high suspicion.

Keywords:
Case reportGallstone ileusGeriatric surgeryHepatobiliaryIntussusceptionSmall bowel obstruction

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Area of Science:

  • Gastroenterology
  • Surgical Case Reports

Background:

  • Gallstone ileus is a significant complication of acute cholecystitis, causing 25% of elderly bowel obstructions.
  • It is rarely reported to present as intussusception, with a previous case resulting in an unfavorable outcome.

Purpose of the Study:

  • To report a unique case of gallstone ileus presenting as intussusception in a patient with a history of cholecystectomy.
  • To emphasize the importance of considering gallstone ileus in elderly patients with small bowel obstruction.

Main Methods:

  • A 69-year-old woman presented with symptoms of acute small bowel obstruction.
  • Computed tomographic imaging revealed a target sign indicative of intussusception.
  • Intraoperative findings identified a gallstone as the cause, and a simple enterolithotomy was performed.

Main Results:

  • The patient, who had undergone cholecystectomy 30 years prior, was diagnosed with gallstone ileus mimicking intussusception.
  • A successful enterolithotomy resolved the obstruction, and the patient became symptom-free.

Conclusions:

  • Gallstone ileus carries a high mortality rate (12-17%) and is a critical differential diagnosis in the elderly.
  • Radiographic findings can be variable, necessitating a high index of suspicion for gallstone ileus in elderly patients with SBO, even with prior gallbladder surgery.