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[Nine consecutive patients with gallstone ileus. Personal experience]

R Grassi1, A Pinto, E Rossi

  • 1Dipartimento di Emergenza, Azienda Ospedaliera di Rilievo Nazionale A. Cardarelli, Napoli.

La Radiologia Medica
|June 25, 1998
PubMed
Summary

Gallstone ileus, a bowel obstruction caused by gallstones, is often diagnosed late. Plain radiographs and ultrasound are sufficient for diagnosis when the stone is calcified, aiding timely intervention.

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Area of Science:

  • Gastroenterology
  • Radiology
  • Abdominal Surgery

Background:

  • Gallstone ileus presents as a mechanical bowel obstruction due to impacted gallstones.
  • Delayed diagnosis is common due to subtle symptoms, leading to a 15% mortality rate.

Purpose of the Study:

  • To review radiologic findings in surgically confirmed gallstone ileus cases.
  • To evaluate the diagnostic efficacy of plain abdominal radiographs, ultrasound (US), and computed tomography (CT).

Main Methods:

  • Retrospective review of 9 consecutive gallstone ileus patients.
  • Analysis of preoperative radiologic procedures: plain films, US, and CT.

Main Results:

  • Rigler's triad (small bowel obstruction, ectopic gallstones, pneumobilia) identified on CT in 4 cases.

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  • Plain films showed Rigler's triad signs in 2 cases; US demonstrated findings in 3 cases.

    • Conclusions:

    • Plain radiographs and US are adequate for diagnosing gallstone ileus when the obstructing stone is radiopaque and calcified.
    • These imaging modalities can obviate the need for further studies in such cases.