A febrile occlusion revealing a biliary ileus

Boudou, Mohamed; Jabi, Rachid; Maamar, Khalil; Haitam, Soussan; Taibi, Soufiane; Bouziane, Mohammed

doi:10.1016/j.ijscr.2022.107113

Cited by 3 publications

(1 citation statement)

References 8 publications

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“…During this period, usually no emergencies or complications occur and surgical enterolithotomy as a treatment is sufficient (10,16). If during follow-up investigation fistula persists and causes symptoms -second stage operation -fistula closure should be considered (17).…”

Section: Fig 1 the Choice Of The Surgical Tactics According To The Lo...mentioning

confidence: 99%

Surgical Management of Cholecystoenteric and Cholecystocolonic Fistulas in Gallstone Ileus: Case Report

Bradūnaitė,

Spooren,

Kobeckis

et al. 2024

Health Sciences

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Gallstone ileus (GI) is a serious complication of choledocholithiasis leading to high mortality because it manifests with mostly unspecific mechanical bowel obstruction symptoms such as abdominal pain, nausea, vomiting and constipation. Conservative treatment of GI is very rarely successful and non-invasive treatment methods provide ambiguous results. Surgery is the preferred treatment tactics for GI. The choice between surgical treatment types depends on the localization of the fistula between the gallbladder and the bowel, and patient’s general medical condition. Enterolithotomy is a surgical procedure proven to be safe and effective in patients with multiple comorbidities who might experience intraoperative and postoperative complications if longer and extended surgeries were to be performed. For those patients who are healthy enough to avoid certain intra- and post-operative complications, the surgery type is chosen according to the anatomical site of the fistula. Cholecystoduodenal and cholecystoenteric fistulas tend to close spontaneously and only a minor part of them leave open leading to an increased risk of complications and to the need of a second-stage surgery. Therefore, a ‘watch and wait’ strategy could be implemented by performing enterolithotomy at first with the subsequent follow-up to check for the fistula closure. Cholecystocolonic fistulas do not tend to close naturally, therefore they should be closed during a one-stage surgery as soon as possible in order to avoid the unwanted complications i.e., reflux cholangitis.

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Section: Fig 1 the Choice Of The Surgical Tactics According To The Lo...mentioning

confidence: 99%

Surgical Management of Cholecystoenteric and Cholecystocolonic Fistulas in Gallstone Ileus: Case Report

Bradūnaitė,

Spooren,

Kobeckis

et al. 2024

Health Sciences

View full text Add to dashboard Cite

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Gallstone ileus presenting in an elderly patient: A case report

González-Robles,

Menéndez-Goti,

de Jesús González-Luna

et al. 2024

International Journal of Surgery Case Reports

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Case Report: Gallstone ileus management - Case report and review of the literature

Dallagi,

Ferjaoui,

Omry

et al. 2024

F1000Res

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Gallstone ileus, a rare complication of cholelithiasis, presents significant morbidity and mortality challenges, with no established consensus on optimal management. This study aimed to highlight the complexities surrounding its occurrence and emphasize the need for tailored therapeutic strategies. An 88-year-old female, with a history of type 2 diabetes mellitus presented with diffuse abdominal pain and vomiting. Clinical evaluation revealed signs of small-bowel obstruction. Radiological assessments, including Computed Tomography CT) scans, confirmed biliary ileus, showcasing a sizable gallstone causing subacute obstruction. Emergency surgery involving enterolithotomy was performed, successfully addressing the immediate concerns. Postoperative follow-up demonstrated a one-year asymptomatic period, emphasizing the effectiveness of the chosen intervention. Gallstone ileus typically follows acute cholecystitis, leading to gallstone erosion and fistula formation commonly in the duodenum. Diagnosis is challenging because of nonspecific symptoms, necessitating a high index of suspicion. Computed tomography (CT) plays a pivotal role in accurate and rapid diagnoses. This study delves into the intricate details of gallstone ileus presentation, complications, and the debate surrounding optimal surgical management, acknowledging the effectiveness of the two-stage procedure and emerging laparoscopic approaches. This case provides valuable insights into the intricate facets of gallstone ileus and emphasizes the need for individualized treatment strategies. Successful management, as demonstrated in our case, underscores the importance of considering patient-specific factors when choosing between the surgical approaches. This study supports recent reports advocating for laparoscopic interventions, encouraging further exploration of evolving therapeutic modalities for gallstone ileus.

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A febrile occlusion revealing a biliary ileus

Cited by 3 publications

References 8 publications

Surgical Management of Cholecystoenteric and Cholecystocolonic Fistulas in Gallstone Ileus: Case Report

Surgical Management of Cholecystoenteric and Cholecystocolonic Fistulas in Gallstone Ileus: Case Report

Gallstone ileus presenting in an elderly patient: A case report

Case Report: Gallstone ileus management - Case report and review of the literature

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