Gallstone ileus associated with impaction at Meckel’s diverticulum: Case report and literature review

Lamba, Harveen; Shi, Yiwen; Prabhu, Ajita S.

doi:10.4240/wjgs.v8.i11.755

Cited by 7 publications

(7 citation statements)

References 31 publications

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“…The ileum was the SOI most frequently observed in both IGSI and RGSI. This observation is consistent with other findings [ 5 , 23 , 31 , 34 , 35 , 63 , 67 , 70 – 73 ]. However, one notable aspect was that SOI was identical in approximately 70% of cases in IGSI and RGSI; that is, in RGSI, the ileum was not the predominant SOI in patients who had impaction at the jejunum in IGSI.…”

Section: Discussionsupporting

confidence: 94%

The Regularity of the Site of Impaction in Recurrent Gallstone Ileus: A Systematic Review and Meta-Analysis of Reported Cases

Alzerwi

Idrees

Alsareii

et al. 2021

Canadian Journal of Gastroenterology and Hepatology

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Objective. Due to the rarity of recurrent gallstone ileus (RGSI), its epidemiological and clinical features are elusive. With a focus on mortality and the site of impaction, this study consolidates the key clinical characteristics of index GSI (IGSI) and RGSI. Methods. A meta-analysis of cases reported on RGSI was performed. Risk factors for mortality and site of impaction were examined, and a subgroup analysis was performed for age, sex, and site of impaction (jejunum, ileum, or others). Results. In the final analysis, 50 (56 individual cases) studies were included. The paired data for the site of impaction was available for 45 patients. Women accounted for 87.3% of all RGSI cases included in the pooled analysis. The median age (interquartile range, IQR) of the patients was 70 (63–76) years, and the median time of recurrence (IQR) was 20.5 (8.5–95.5) days. The overall mortality rate was 11.8%, without correlation between the mortality rate and age, the time of recurrence, or the site of impaction. The region in which the stone was found in RGSI and IGSI was similar in most cases p = 0.002 . Logistic regression also revealed a higher probability of stone impaction in the ileum in RGSI if it was the site of impaction in IGSI. In most cases, enterolithotomy was the preferred method. Conclusions. A high index of suspicion for RGSI should be maintained for older women with a history of GSI. The region where the stone was impacted during IGSI should be investigated first in such patients.

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Section: Discussionsupporting

confidence: 94%

The Regularity of the Site of Impaction in Recurrent Gallstone Ileus: A Systematic Review and Meta-Analysis of Reported Cases

Alzerwi

Idrees

Alsareii

et al. 2021

Canadian Journal of Gastroenterology and Hepatology

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“…При этом наиболее часто встречается инвагинация и заворот кишок [5]. Возникновение непроходимости тонкой кишки из-за фитобезоара в дивертикуле Меккеля является редким состоянием и описано в литературе в единичных случаях [11,12,13].…”

Section: Discussionunclassified

“…Так во всех описанных случаях ОКН из-за фитобезоара дивертикула Меккеля выполнялась резекция участка кишки с дивертиккулом и наложением межкишечного анастомоза или дивертикулэктомия [11,12,13]. Большинство случаев, описанных в литературе, были обработаны с помощью открытой лапаротомии.…”

Section: Discussionunclassified

Acute small bowel obstruction caused by phytobezoar Meckel diverticula

Tarasenko

Натальский

Peskov

et al. 2019

jour

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Introduction. Meckel diverticulum-is a residue of not completely reduced yolk duct. Among the occurring complications of Meckel’s cuticle in the adult population, acute intestinal obstruction prevails. In this case, the most common intussusception and inversion of the intestines. The occurrence of small bowel obstruction due to phytobesoar in the Meckel diverticulum is a rare condition and has been described in the literature in isolated cases. Materials and methods. The patient of 29 years entered the surgical Department with complaints of abdominal pain of a permanent nature, violation of the discharge of stool and gases, vomiting up to 4 times. Sick for about 2 days. Fluoroscopy of the abdomen showed multiple arches with small bowel fluid levels, single bowl kloybera. The man was operated on urgently with a diagnosis of acute mechanical small bowel obstruction. Results. During the operation, Meckel’s phytobezoar diverticula was detected, which caused acute small bowel obstruction, for which the fragmentation of the bezoar was performed with its relegation to the cecum. The postoperative period proceeded without complications, the patient was discharged on the 10th day after surgery. After 6 weeks, the patient underwent laparoscopic diverticulectomy as planned. Discharged for 5 days. Conclusion. A clinical case of treatment of a patient with phytobezoar Meckel diverticulum complicated by acute mechanical small bowel obstruction is presented. The use of delayed diverticulectomy can reduce the risk of anastomosis failure in acute intestinal obstruction, and if proper diet is observed, it reduces the risk of recurrent intestinal obstruction before re-planned hospitalization.

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“…(4). In its etiology, there is a wide range of diseases such as abdominal surgery (5), malignant diseases (6), diverticulitis (7), peritonitis (8), mechanical bowel obstruction due to gallstone (9), and inflammatory diseases. Although there are various comorbid factors in its etiology, controversy continues regarding the pathogenesis of mechanical bowel obstruction.…”

Section: Introductionmentioning

confidence: 99%

Incidence and mortality results of intestinal obstruction in geriatric and adult patients: 10 years retrospective analysis

Koşar

Görgülü

2021

Turk J Surg

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Objective: People with ileus is one of the patient groups with the highest admission rates to the emergency departments. In this study, it was aimed to determine the effects of age groups and etiological factors on mortality when evaluated together with gender. Material and Methods: In our study, patients who were consulted from the Emergency Service to the General Surgery department with a pre-diagno- sis of abdominal pain between 2009 and 2020 were retrospectively screened. Patients hospitalized for ileus were analyzed in terms of age (18-65 years and over 65 years), gender, operation, etiology, incidence, and mortality. Results: Between 2009 and 2020, 534 (3.03%) of 17.601 patients who received emergency consultation from the general surgery clinic were diagnosed with ileus. While 253 (47.4%) of the patients were operated, 317 (59.4%) patients and 101 (18.9%) patients were diagnosed with brid and malignancy, respectively; and 21 (3.9%) patients died in the complete patient group (Table 1). While the incidence of brid was high in non-operated patients, in operated patients, malignancy and other pathologies was found to be higher (p< 0.001) (Table 2). While, in patients 65 years and older, mortality was observed in 10.6% of women and 2.6% of men, it was determined that the mortality rate was higher in women (p= 0.008) (Figure 4). Conclusion: The mortality rate in patients hospitalized with the diagnosis of mechanical bowel obstruction was found to be statistically significantly higher in female patients aged 65 and over.

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Gallstone ileus associated with impaction at Meckel’s diverticulum: Case report and literature review

Cited by 7 publications

References 31 publications

The Regularity of the Site of Impaction in Recurrent Gallstone Ileus: A Systematic Review and Meta-Analysis of Reported Cases

The Regularity of the Site of Impaction in Recurrent Gallstone Ileus: A Systematic Review and Meta-Analysis of Reported Cases

Acute small bowel obstruction caused by phytobezoar Meckel diverticula

Incidence and mortality results of intestinal obstruction in geriatric and adult patients: 10 years retrospective analysis

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