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[Determination of gallstone ileus using emergency gastroscopy]
Zeitschrift Fur Die Gesamte Innere Medizin Und Ihre Grenzgebiete
|February 1, 1981
Summary
A 73-year-old female presented with vomiting, initially suspected as pyloric stenosis. Emergency gastroscopy revealed gallstone ileus, leading to immediate surgery for this rare intestinal obstruction.
Area of Science:
- Gastroenterology
- Surgical Pathology
Background:
- Gallstone ileus is a rare complication of cholelithiasis, often presenting with non-specific symptoms.
- Delayed diagnosis can lead to significant morbidity and mortality.
Observation:
- A 73-year-old female experienced 10 days of progressive vomiting.
- Initial radiography suggested pyloric stenosis, but gastroscopy identified gallstones in the duodenal bulb.
- Evidence of a cholecystoduodenal fistula was observed.
Findings:
- Emergency gastroscopy diagnosed gallstone ileus as the cause of the patient's obstructive symptoms.
- Two hazelnut-sized gallstones were found in the duodenal bulb.
- A large, hen's egg-sized gallstone was removed 30 cm distal to the ligament of Treitz.
Implications:
- This case highlights the importance of considering gallstone ileus in elderly patients with unclear gastrointestinal obstruction.
- Endoscopic visualization is crucial for diagnosing biliary-enteric fistulas and gallstone impaction.
- Prompt surgical intervention is necessary for managing gallstone ileus to prevent complications.