Gallstone ileus associated with cholecystogastric fistula: Case report, diagnosis and surgical treatment

Gallstone Ileus is a rare complication of cholelithiasis, associated with multiple episodes of cholecystitis, with the formation of adhesions and fistulas between the gallbladder and adjacent organs. Its diagnosis is difficult, requiring complementary imaging tests such as computed tomography or rad...

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Bibliographic Details
Published in:International journal of surgery case reports 2021-09, Vol.86, p.106328-106328, Article 106328
Main Authors: Rodriguez, Juan Eduardo Rios, Grossi, Ana Elisa de Landa Moraes Teixeira, Siqueira, Victor Ripardo, de Siqueira Filho, Josias Torres, Pereira, Magnum Adriel Santos, da Cunha, Decius Guimarães Carneiro
Format: Article
Language:English
Subjects:
Case Report
Cholecystectomy
Cholelithiasis
Gallstones
General surgery
Intestinal obstruction
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Summary:Gallstone Ileus is a rare complication of cholelithiasis, associated with multiple episodes of cholecystitis, with the formation of adhesions and fistulas between the gallbladder and adjacent organs. Its diagnosis is difficult, requiring complementary imaging tests such as computed tomography or radiography. Female patient, with intestinal obstruction for 7 days, associated with abdominal pain and previous episodes of pain in the right hypochondrium for 3 months. Abdominal CT scan identified aerobilia, gallstone impacted in the ileocecal valve and small loop dilatation, in addition to a probable cholecystogastric fistula. Opted for exploratory laparotomy, enterolithotomy and fistula correction in one surgical time. Gallstone ileus is rare among the complications of cholelithiasis, in addition to the fact that cholecystogastric fistula is associated with gastric pylorus obstruction and not impaction on the ileocecal valve. Imaging tests are useful to complement the diagnosis, and if Rigler's triad is present, the suspicion of gallstone ileus is increased. The presence of fistula between the gallbladder and stomach presents a frequency between 0 and 13.3%. There is no gold standard treatment for gallstone ileus, but surgery options for each type of patient and severity level. There is no definitive protocol for optimal surgical treatment for biliary ileus, but the possibility of enterolithotomy associated with cholecystectomy and fistula correction can be evaluated in selected patients. •Gallstone ileus is a rare cause of intestinal obstruction.•Cholecystogastric fistula may be associated with ileum obstruction.•One-step surgical treatment can be used in specific patients
ISSN:2210-2612
2210-2612
DOI:10.1016/j.ijscr.2021.106328