Gallstone ileus: A rare and often disregarded cause of intestinal obstruction: Case report with literature review

Abstract

Gallstone ileus is very rare complication of cholelithiasis. As it is usually a disease of the elderly, the morbidity and mortality associated with it is high due to the presence of co-morbidities. This is additionally made worse by the delay encountered before reaching diagnosis which often demands a high index of suspicion. In Ethiopia, a country where intestinal obstruction is seen to be one of the common presentations in the emergency surgical department, gall stone has never been seen to be reported as a cause. Thus we present this rare case and discuss the mode of presentation, diagnostic difficulties and differing treatment options. We report the case of an 80-year old lady who presented with signs and symptoms of small intestinal obstruction. Upon exploration we were astonished to find the cause of the obstruction to be a gallstone which was removed by simple ileostomy. Postoperative course was uneventful.

Epidemiology and causes of intestinal obstruction in Ethiopia: A systematic review

“…On examination, the SBO caused by gallstones was detected and removed by a simple ileostomy. 55 Moreover, three cases of Meckel’s diverticulum were observed. 35 , 56 …”

“…Such causes of small intestine have also been reported previously in the literature. 55 , 66 In particular, gossypiboma is an ethico-medical issue that needs due attention from clinicians and other stakeholders. The cases were reported among post-cesarean section women, which signify the need to take precautions during cesarean surgical procedures since the highest prevalence of cesarean delivery beyond the WHO recommendation has been reported in Ethiopia and other African countries.…”

“…On examination, the SBO caused by gallstones was detected and removed by a simple ileostomy. 55 Moreover, three cases of Meckel's diverticulum were observed. 35,56 A cross-sectional study illustrated five cases of small intestine obstruction due to ascariasis lumbricoides among 297 patients.…”