Gallstone Ileus Treated by Incidental Meckel's Diverticulectomy

Area of Science:

• Gastroenterology
• Surgical Innovation
• Abdominal Surgery

Background:

• Gallstone ileus is an infrequent cause of intestinal obstruction, primarily affecting the elderly population.
• Diagnosis often relies on computed tomography (CT) scans revealing pneumobilia and a gallstone in the right iliac fossa.
• It is crucial to consider gallstone ileus as a potential indicator of other underlying pathologies.

Observation:

• A case of gallstone ileus is presented where the gallstone was lodged in the terminal ileum.
• An incidentally discovered Meckel's diverticulum was located distal to the impacted gallstone.
• The gallstone was successfully manipulated proximally into the Meckel's diverticulum.

Findings:

• The gallstone was retrieved by milking it into the Meckel's diverticulum.
• The base of the Meckel's diverticulum was subsequently transected.
• This approach facilitated the removal of the obstructing gallstone.

Implications:

• This case highlights a rare and innovative surgical technique for managing gallstone ileus.
• Utilizing a small bowel diverticulum as a vector for gallstone removal offers a unique solution.
• This method may be considered in complex cases of gallstone ileus where conventional approaches are challenging.