Mechanical intestinal occlusion due to gallstone ileus. Case report

Authors

Keywords:

biliary ileus, mechanical intestinal obstruction, gallstones

Abstract

Obstruction of the lumen of the small intestine by an abnormally located gallstone, incorrectly called gallstone ileus, accounts for 1% to 3% of all obstructive bowel syndromes. It is defined as an unusual entity characterized by mechanical intestinal obstruction, caused by the impact of one or several gallstones in the intestinal lumen, usually in the terminal ilium. The objective is to describe the present case due to the infrequency of this entity, to describe the diagnostic system and conduct taken, as well as to carry out the analysis of the related literature. An 87-year-old female patient presented with symptoms of vomiting and abdominal distension of 20 days of evolution, with an unusual, very poor general condition, characterized by mechanical intestinal obstruction caused by the impact of one or several gallstones in the intestinal lumen, usually in the terminal ilium. An exploratory laparotomy was performed, where a large stone of approximately 4 cm was observed in the proximal ileum which completely obstructed the lumen. Enterolithotomy and bowel resection were performed without intervention in the gallbladder or bile duct. She died on the third day of the immediate postoperative period due to decompensation of her cardiovascular disease. It is concluded that gallstone ileus is a rare entity without studies that standardize a specific treatment and that it requires surgical intervention. Enterotomy for stone removal is a safe and effective technique without the need for intervention in the bile duct in the first time.

Downloads

Download data is not yet available.

Author Biographies

Alberto Suárez-Cuevas, Instituto Nacional de Oncología y Radiobiología. La Habana

Especialista de I grado en Cirugía General y en Medicina General Integral Diplomado en Cirugía Oncológica Profesor Asistente Investigador Agregado

Olga Noemí Rodríguez-Marrero, Instituto Nacional de Oncología y Radiobiología. La Habana

Especialista de I grado en Oncología Clínica y en Medicina General Integral Diplomado en Mastología Máster en Diseño y Conducción de Ensayos Clínicos Investigador Agregado

Giselle Albertini-López, Centro de Investigaciones sobre Longevidad, Envejecimiento y Salud. La Habana

Especialista de II grado en Cirugía General Máster en Investigaciones de Climaterio y Menopausia Profesora Auxiliar

References

1. Townsend CM, Daniel Beauchamp R, Mark Evers B, et al. Sabiston Textbook of Surgery the Biological Basis of Modern Surgical Practice (Townsend) [Internet]. Amsterdam: Elsevier; 2021 [citado 03/05/2023]. Disponible en: https://archive.org/details/sabiston-textbook-of-surgery-the-biological-basis-of-modern-surgical-practice-townsend-ed-21-2021/page/n11/mode/2up

2. Soler Vaillant R, Mederos Curbelo O. Cirugía. T. 5. Afecciones del abdomen y otras especialidades quirúrgicas. La Habana: Editorial Ciencias Médicas; 2018.

3. Sánchez-Pérez EA, Álvarez-Álvarez S, Madrigal-Téllez MA, et al. Gallstone ileus, experience in the Dr. Eduardo Liceaga General Hospital of Mexico. Cir Cir. 2017;85(2):114-20. DOI: 10.1016/j.circir.2016.05.018.

4. Salazar-Jiménez MI, Alvarado-Durán J, Fermín-Contreras MR, et al. Gallstone ileus, surgical management review. Cir Cir. 2018;86(2):182-6. DOI: 10.24875/CIRU.M18000032.

5. López Alesio E, Ortega Elías E, López Flavia G, et al. Íleo biliar. Una entidad que perdura en el tiempo. Rev Argent Cir [Internet]. 2021 [citado 26/11/2023];113(1):56-61. Disponible en: http://www.scielo.org.ar/scielo.php?script=sci_arttext&pid=S2250-639X2021000100056&lng=es

6. Ploneda Valencia CF, Gallo Morales M, Rinchon C, et al. Gallstone ileus: An overview of the literature. Rev Gastroenterol Mex. 2017;82(3):248-54. DOI: 10.1016/j.rgmx.2016.07.006.

7. Beji H, Chtourou MF, Zribi S, et al. Gallstone ileus: A case report and review of the literature. Int J Surg Case Rep. 2023;106:108221. DOI: 10.1016/j.ijscr.2023.108221.

8. Ríos Rodríguez JE, de Landa Moraes Teixeira Grossi AE, Ripardo Siqueira V, et al. Gallstone ileus associated with cholecystogastric fistula: Case report, diagnosis and surgical treatment. Int J Surg Case Rep. 2021;86:106328. DOI: 10.1016/j.ijscr.2021.106328.

9. Hurtado Yady V, Agudelo Hanier, Merchán-Galvis ÁM. Íleo biliar en adulto joven. Reporte de un caso. Univ Salud. 2019;22(1):96-101. DOI: 10.22267/rus.202201.180.

10. Gandhi H, Joshi A. Single stage totally laparoscopic management of Barnard’s syndrome: the first such case report with review of literature. Int Surg J. 2022;9(12):2079-83. DOI: 10.18203/2349-2902.isj20223177.

11. Gupta AK, Vazquez OA, Yeguez JF, et al. Laparoscopic Approach for Gallstone Ileus in Geriatric Patients. Cureus [Internet]. 2020 [citado 03/05/2023];12(6):e8642. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7364424/

12. Vera-Mansilla C, Sánchez-Gollarte A, Matías B, et al. Surgical Treatment of Gallstone Ileus: Less Is More. Visc Med. 2022;38(1):72-7. DOI: 10.1159/000518451.

Downloads

Published

2023-12-16

How to Cite

1.
Suárez-Cuevas A, Rodríguez-Marrero ON, Albertini-López G. Mechanical intestinal occlusion due to gallstone ileus. Case report. Rev Méd Electrón [Internet]. 2023 Dec. 16 [cited 2025 Jan. 10];45(6):e5279. Available from: https://revmedicaelectronica.sld.cu/index.php/rme/article/view/5279

Issue

Vol. 45 No. 6 (2023)

Section

Presentation of cases

License

All content published in this journal is Open Access, distributed under the terms of the CC BY-NC 4.0 License.

It allows:

 - Copy and redistribute published material in any medium or format.

 - Adapt the content.

 This will be done under the following terms:

 - Attribute the authors' credits and indicate whether changes were made, in which case it must be in a reasonable way.

 - Non-commercial use.

 - Recognize the journal where it is published.

 The copyrights of each article are maintained, without restrictions.

Most read articles by the same author(s)