Gallstone Ileus: Dilemma in the Management.

Area of Science:

• Gastroenterology
• Surgical Gastroenterology
• Abdominal Surgery

Background:

• Gallstone ileus is a rare complication of gallstones, causing mechanical intestinal obstruction.
• The optimal surgical approach, one-stage versus two-stage, remains a subject of debate.

Observation:

• A 69-year-old male presented with symptoms of gallstone ileus.
• He underwent a one-stage procedure involving enterolithotomy and duodenal fistula closure.

Findings:

• The patient experienced immediate postoperative recovery but later developed respiratory complications.
• Ultimately, he succumbed to multi-organ failure three weeks post-surgery.

Implications:

• Enterolithotomy alone is common but not always definitive for gallstone ileus.
• The case underscores the difficulty in choosing between one-stage and two-stage procedures without clear guidelines.
• Further research is needed to establish a consensus on the definitive management of gallstone ileus.