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[Nine consecutive patients with gallstone ileus. Personal experience]
1Dipartimento di Emergenza, Azienda Ospedaliera di Rilievo Nazionale A. Cardarelli, Napoli.
La Radiologia Medica
|June 25, 1998
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.
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.
- 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.