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Year : 2017  |  Volume : 50  |  Issue : 3  |  Page : 117-118

Gallstone ileus

Department of Surgery, Division of General Surgery, Chung Shan Medical University Hospital, Taichung, Taiwan

Date of Submission31-Oct-2016
Date of Decision12-Dec-2016
Date of Acceptance21-Dec-2017
Date of Web Publication29-May-2017

Correspondence Address:
Wei-Hsin Chen
40201, No. 110, Sec. 1, Jianguo N. Rd., Taichung
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/fjs.fjs_39_17

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How to cite this article:
Chen WH. Gallstone ileus. Formos J Surg 2017;50:117-8

How to cite this URL:
Chen WH. Gallstone ileus. Formos J Surg [serial online] 2017 [cited 2020 Sep 23];50:117-8. Available from: http://www.e-fjs.org/text.asp?2017/50/3/117/207185

A 63-year-old female patient with a history of gallstones was presented to the emergent department because of intermittent abdominal pain for 3 days. The associated symptoms were abdominal fullness and postprandial vomiting. The radiography of abdomen showed dilated small bowel loops in the left upper quadrant abdomen and a radiopaque stone in the right lower quadrant of the abdomen [Figure 1]a. The abdominal computed tomography (CT) scan showed disappear of all gallstones from the gallbladder [Figure 2]a, cholecystoduodenal fistula [Figure 2]b, and a 3-cm gallstone in the lumen of terminal ileum [Figure 2]c resulted in proximal dilatation and distal collapse. Tracing her previous abdominal radiography 10 months ago, a radiopaque stone was located in the right upper quadrant abdomen [Figure 1]b. The CT scan at that time showed distended gallbladder with big gallstone pushing the duodenum [Figure 3]a and [Figure 3]b. Under the impression of gallstone ileus, emergent laparotomy was arranged. On exploration, a gallstone impacted in the distal small bowel resulted in proximal dilatation, and distal collapse was noted. Due to difficulty in repelling the stone into colon, we made an enterotomy and removed the stone. We did not remove the gallbladder at the same time because there were no residual stones in it on CT scan. Besides, doing one-stage procedure (including enterolithotomy, cholecystectomy and fistula closure) will need a long midline incision and longer operation time. Hence, we chose only enterolithotomy to avoid possible complications related to one-stage procedure. After operation, the patient recovered well and was discharged on postoperative day 7. She is doing well 2 years after the operation.
Figure 1: The abdominal radiography showed different location of the gallstone on admission (figure 1a) and 10 months ago (figure 1b)

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Figure 2: The abdominal CT scan on admission showed disappear of all gallstones from the gallbladder (Figure 2a), cholecystoduodenal fistula (Figure 2b), and a 3- cm gallstone in the lumen of terminal ileum (Figure 2c)

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Figure 3: The abdominal CT scan 10 months before admission showed distended gallbladder with big gallstone pushing the duodenum (Figure 3a and b)

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Declaration of patient consent

The author certifies that he has obtained all appropriate patient consent forms. In the form the patient has given her consent for her images and other clinical information to be reported in the journal. The patient understands that her name and initial will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

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Conflicts of interest

There are no conflicts of interest.


  [Figure 1], [Figure 2], [Figure 3]


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