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Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation

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Gallstone ileus with spontaneous evacuation: A case report.

Koji Takahashi¹, Hiroshi Kashimura¹, Naoaki Konno¹

¹Department of Gastroenterology Mito Saiseikai General Hospital Ibaraki Japan.

Journal of General and Family Medicine

|September 7, 2018

Summary

A large gallstone caused a small bowel obstruction (gallstone ileus) in a 65-year-old man. Non-surgical treatment with a nasal ileus tube successfully resolved the obstruction, leading to spontaneous stone evacuation.

Keywords:

cholecystoduodenal fistula gallstone ileus spontaneous evacuation

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Area of Science:

Gastroenterology
Abdominal Surgery

Background:

Gallstone ileus is a rare complication of gallstones, typically occurring in elderly patients.
It presents with symptoms of small bowel obstruction due to a gallstone impacted in the gastrointestinal tract.

Observation:

A 65-year-old male presented with abdominal pain and a history of enterotomy for gallstone ileus.
Abdominal CT revealed a 32 x 28 mm stone obstructing the jejunum.

Findings:

The patient was treated non-surgically with a nasal ileus tube for gallstone ileus.
Follow-up CT demonstrated the stone had migrated to the rectum and was spontaneously evacuated.
A duodenal fistula communicating with the gallbladder was identified post-evacuation.

Implications:

This case highlights the potential for conservative management of gallstone ileus.
Spontaneous stone passage and resolution can occur, even with large stones.
The presence of a cholecystoduodenal fistula was confirmed after conservative treatment.