Abstract
Background A 79-year-old white woman presented with upper abdominal pain. She had a history of rheumatoid arthritis since she was 19 years old, which was treated with prednisolone, leflunomide, diclofenac and pantoprazole. She also had factor VII deficiency. The patient had been hospitalized 2 months previously with sepsis presumed to be due to urinary infection, and was treated with antibiotics. Sonography at this time revealed a gallbladder with a monstrous thick wall and stones, and the first differential diagnosis was cholecystitis. Cholecystectomy was planned after amelioration of the patient's general state, but her general state worsened.
Investigations Sonography, endoscopy of the upper and lower intestine, and CT scan.
Diagnosis Biliodigestive fistula and gallstone ileus.
Management Enterolithotomy, stenting, endoscopic retrograde cholangiopancreatography, and surgery.
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References
Reisner RM and Cohen JR (1994) Gallstone ileus: a review of 1001 reported cases. Am Surg 60: 441–446
Kunin N et al. (2004) Gallstone ileus disclosed by a stone in the rectum. Gastroenterol Clin Biol 28: 1184–1185
Cheng H et al. (2004) Image of the month. Gallstone ileus. Gastroenterology 127: 705
Graham JS and Rothwell BC (2004) Images in clinical medicine. Gallstone ileus. N Eng J Med 351: 1119
Buljevac M et al. (2004) Sonographic diagnosis of gallstone ileus. J Ultrasound Med 23: 1395–1398
Yoshida H et al. (2004) Diagnosis of gallstone ileus by serial computed tomography. Hepatogastroenterology 51: 33–35
Meyenberger C et al. (2000) Gallstone ileus treated by extracorporeal shockwave lithotripsy. Gastrointest Endosc 51: 209–213
Dumonceau JM et al. (1996) Extracorporeal shock-wave lithotripsy for gallstone ileus. Gastrointest Endosc 44: 759
Langhorst J et al. (2000) Successful endoscopic therapy of a gastric outlet obstruction due to a gallstone with intracorporeal laser lithotripsy: a case of Bouveret's syndrome. Gastrointest Endosc 51: 209–213
Clavien PA et al. (1990) Gallstone ileus. Br J Surg 77: 737–742
Rodriguez-Sanjuan JC et al. (1997) Cholecystectomy and fistula closure versus enterolithotomy alone in gallstone ileus. Br J Surg 84: 634–637
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Glossary
- CHOLECYSTITIS
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Inflammation of the gallbladder
- ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY
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Endoscopic technique of injecting contrast dye into the ampulla of Vater for radiologic visualization of the pancreatic and biliary ducts
- LITHOTRIPTOR
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An instrument that is used to catch stones in the common bile duct and destruct them in situ by mechanical compression
- MISERERE
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Bowel fluid
- GALLSTONE ILEUS
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When a gallstone migrates into the duodenum by penetration because of cholecystitis and blocks the intestine (normally at Bauhin's valve)
- ILEOCOLONOSCOPY
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Endoscopic procedure inspecting the terminal ileum, Bauhin's valve, the colon and the rectum
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Zuber-Jerger, I., Kullmann, F., Schneidewind, A. et al. Diagnosis and treatment of a patient with gallstone ileus. Nat Rev Gastroenterol Hepatol 2, 331–335 (2005). https://doi.org/10.1038/ncpgasthep0211
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DOI: https://doi.org/10.1038/ncpgasthep0211