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Íleo Biliar: Un Caso Raro de Obstrucción Intestinal
Joana Rodrigues Ferreira1, Tomás Matos Nunes1, Madalena Costa1
1General Surgery, Unidade Local de Saúde de Lisboa Ocidental, Lisbon, PRT.
Cureus
|January 22, 2026
Resumen
El íleo biliar, una obstrucción intestinal rara, requiere un diagnóstico y manejo rápidos. Este caso destaca el tratamiento exitoso con enterolitotomía y litotricia electrohidráulica en un paciente anciano frágil.
Área de la Ciencia:
- Gastroenterología; Cirugía Gastroenterológica; Enfermedades del Sistema Digestivo
Sus antecedentes:
- El íleo biliar es una obstrucción intestinal mecánica rara causada por cálculos biliares que impactan en el tracto gastrointestinal, a menudo secundaria a una fístula colecistoentérica.; Afecta predominantemente a personas de edad avanzada con comorbilidades, lo que lleva a un diagnóstico tardío debido a síntomas inespecíficos.; El íleo biliar se asocia con altas tasas de morbilidad y mortalidad, y su manejo óptimo sigue siendo controvertido.
Objetivo del estudio:
- Presentar un caso de íleo biliar en un paciente de edad avanzada.; Discutir los desafíos diagnósticos y de manejo.; Destacar la efectividad de enfoques menos invasivos en pacientes frágiles.
Principales métodos:
- Informe de caso de un hombre de 84 años con síntomas de obstrucción intestinal.; Se utilizaron imágenes diagnósticas para una evaluación rápida.; La intervención quirúrgica implicó enterolitotomía longitudinal seguida de endoscopia gastrointestinal superior con litotricia electrohidráulica.
Principales resultados:
- El paciente presentó vómitos fecaloideos, intolerancia a la alimentación y dolor epigástrico, indicativos de oclusión mecánica intestinal debida a íleo biliar.; La enterolitotomía y la litotricia electrohidráulica fragmentaron con éxito el cálculo biliar.; El paciente experimentó un resultado favorable sin recurrencia de síntomas dentro de los seis meses posteriores a la cirugía.
Conclusiones:
- Los enfoques menos invasivos, como la enterolitotomía y la litotricia, pueden ser efectivos en el manejo del íleo biliar en pacientes ancianos frágiles.; El diagnóstico rápido y el manejo individualizado son cruciales para mejorar los resultados.; Este caso subraya la importancia de considerar opciones conservadoras y mínimamente invasivas para pacientes de alto riesgo.
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