Diagnosis and treatment of gallstone intestinal obstruction in an adult patient
Namık Kemal University Medical Faculty, Department of Surgery, Tekirdag, TURKEY.
Case Study
World Journal of Advanced Research and Reviews, 2021, 09(02), 090-094
Article DOI: 10.30574/wjarr.2021.9.2.0044
Publication history:
Received on 28 January 2021; revised on 06 Februay 2021; accepted on 08 Februay 2021
Abstract:
Background: Gallstone ileus, which is called Type Vb Mirizzi Syndrome, is a rare case of mechanical intestinal obstruction observed in older patients with history of cholelithiasis or cholecystitis. Diagnostic Imaging plays an important role in the management of patients with suspected gallstone ileus. X-Ray and Abdominal Computed Tomography (CT) are the preferred modality.
Case presentation: The patient was diagnosed with gallstone ileus at the age of 45. The case had 10 years history of biliary colic disease. The patient who is suffered from intestinal obstruction. CT demonstrated pneumobilia involving the gallbladder, a 5, 5 cm calcified stone in the ileum and small bowel dilatation. He underwent enterolithotomy and a huge stone was removed. When gallbladder area was checked, the gallbladder was highly adherent (to colon and stomach) and was inflamed. We suspected malignancy so multipl biopsy was taken. Two-stage treatment model was planned. After the surgery, any emerging complications were closely monitored.
Conclusions: Abdominal CT are the preferred modality for diagnosis. The main treatment for gallstone intestinal obstruction is surgery. First step enterotomy, later intented for the gallbladder. There are two type of surgical approach for gallbladder: one-stage treatment or two-stage treatment according the inflammation of gallbladder
Keywords:
Gallstone; Bile ileus; Cholecystoduodenal fistula; Intestinal obstruction
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