Clinical outcome of gallstone ileus; a single-centre experience of case series and review of the literature

Abdominal Pain and Hypotension in a 70-Year-Old Woman

“…2,8,9 However, a 1-step procedure may be considered for patients at low risk of surgical complications to decrease the likelihood of gallstone recurrence, retrograde cholecystitis, and gallbladder cancer. 6 Recurrent gallstone ileus occurs in approximately 5% of patients treatedwithenterolithotomy,with85%ofrecurrencesoccurringwithin 6 months of surgery. 5 Despite surgical treatment, gallstone ileus is as-sociatedwithamortalityrateof7%to30%,inpartduetotheadvanced age and multiple medical comorbidities of most patients.…”

“…Gallstone ileus represents 1% to 4% of all cases of mechanical gastrointestinal obstruction but accounts for up to 25% of bowel obstruction in patients older than 65 years . Gallstone ileus occurs most commonly in older patients (mean age, 74 years), and 80% to 90% have multiple medical conditions, including hypertension, diabetes, and ischemic heart disease . Between 72% and 90% of patients with gallstone ileus are women, and approximately 50% of patients have no history of gallbladder disease .…”

“…Although no randomized clinical trials currently exist to support a preferred surgical treatment, enterolithotomy alone is the most commonly performed surgical procedure for gallstone ileus and has been associated with lower mortality rates and fewer immediate postoperative complications than alternative surgical options . However, a 1-step procedure may be considered for patients at low risk of surgical complications to decrease the likelihood of gallstone recurrence, retrograde cholecystitis, and gallbladder cancer …”

Difficult Management of Giant Gallstone Ileus of a Post-cardiopulmonary Resuscitation Patient: A Case Report

“…On physical examination, there may be abdominal tenderness and distention; however, there is no obvious specific finding. [5] The Rigler triad (pneumobilia, presence of abnormal gallstones, and intestinal obstruction) can be seen at a rate of 40-50% on plain abdominal x-ray [6]. All the three signs of Rigler's triad can be seen together only in 15% of the cases on plain abdominal x-rays [7].…”

Cholecystoduodenal fistula and gallstone ileus - diagnosis and surgical treatment

“…Surgical approaches for managing the gallbladder and cholecystoenteric fistulas remain debated due to worse postoperative outcomes compared to enterolithotomy alone. Spontaneous closures of cholecystoenteric fistula were reported leading to a reduction in the need for surgical intervention in the second stage [4,12,13,14]. Our surgical approach was enterolithotomy alone because surgical management of the gallbladder and cholecystoenteric fistula in high-risk patient was difficult due to severe adhesions and no possibility of safely identifying the contents of Calot's triangle.…”