Obstrucción intestinal secundaria a íleo biliar: reporte de caso

Morales-Ortiz, Jorge A; Cota-Novoa, Manuel M.; Mora, G; Salinas-Quintero, Xavier E.; A, González-García

doi:10.24875/ciru.21000022

Cited by 3 publications

(4 citation statements)

References 4 publications

(10 reference statements)

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“…2 According to the literature, stones larger than 2.5 cm are the most likely to be retained, most are impacted in the ileum (50%-70%), followed by the jejunum (20-40%), the stomach and the duodenum (10%), colonic obstruction being very rare. 7 There are pathological variants of gallstone ileus, Bouveret´s syndrome described in 1896 which is the result of the stone travels retrograde to the duodenal bulb where it prevents gastric emptying, occurs in 3% of patients. 1,2 Another variant known as Barnard syndrome occurs when stones obstruct the ileocecal valve, manifesting as a classic bowel obstruction.…”

Section: Discussionmentioning

confidence: 99%

“…2,10 Ultrasound has a sensitivity of 78%, while contrast-enhanced computed tomography (CT) has a sensitivity of 93% and a specificity close to 100%, which is why it is considered the reference method, with CT is possible to find the triad Rigler in 78% of cases. 7,11 When water-soluble oral contrast is used, it is possible to observe the Forchet sign or "snake's head" (presence of a clear halo of contrast medium around the stone) or the Petren sign (passage of contrast medium to the biliary tract). 12 About the treatment of GI, there are 3 main surgical options: enterotomy with stone extraction alone, enterotomy with stone extraction plus cholecystectomy and bilioenteric fistula repair in 1-phase time, and the 2phase procedure, which includes enterotomy with initial stone extraction with subsequent cholecystectomy and fistula repair.…”

Section: Discussionmentioning

confidence: 99%

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Gallstone ileus, controversies on current surgical management

Madrid Ruíz,

Hidalgo Artiaga,

Baéz León

et al. 2023

Int Surg J

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Among the causes of bowel obstruction, the gallstone ileus represents a rare etiology in the general population, however, the incidence of cases increases in older adults. To make its diagnosis, a high clinical suspicion and extension studies are required. It is considered a surgical emergency, although the ideal approach continues to be debated today. We present the case of a 78-year-old patient with clinical and imaging findings compatible with gallstone ileus, the diagnostic and therapeutic approach, as well as a wide review of the literature about current surgical option.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Gallstone ileus, controversies on current surgical management

Madrid Ruíz,

Hidalgo Artiaga,

Baéz León

et al. 2023

Int Surg J

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show abstract

“…These stones must be symptomatic or cause any type of complication [ 2 ]. One of the rare complications of gallstones apart from the well-known dyspeptic disorder or pain can be intestinal obstruction occurring as a cause in 1–3% [ 3 ]. Here, we present two cases of an ileus caused by gallstones.…”

Section: Introductionmentioning

confidence: 99%

Gallstone as a cause of intestinal obstruction (Bouveret syndrome)

Monteiro,

Schmid,

Mischinger

et al. 2023

Journal of Surgical Case Reports

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Gallstone ileus is a rare cause of bowel obstruction. Here we report about two cases with clinical findings and therapy options. Both patients were presented with typical ileus-like symptoms, although the surgical treatment differs due to the CT scan and intraoperative findings. There are many methods for treating patients with Bouveret syndrome. Endoscopy should be the first treatment option for young patients with no significant diseases in the medical history, depending on the size of the stone. Surgical approach is the next possible option. Combination of these two methods is associated with higher mortality. In case there is no extraluminal gas or intraperitoneal fluid in CT-scan, there is no need for an acute surgery. Conservative therapy prior to the intervention enables a precise planning of whether the endoscopic approach or open surgery would be beneficial for the patient.

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“…Intestinal obstruction occurs due to the spontaneous formation of a biliary-enteric fistula, mainly in the ileum but less commonly in the duodenum and stomach. Colonic obstructions are rare, as the size of the gallstones allows them to pass through the colon lumen 6 , 7 . Successful endoscopic therapy for enteric gallstone impaction is limited, and surgical intervention is often required 5 .…”

Section: Introductionmentioning

confidence: 99%

Small intestinal obstruction due to a giant gallstone: a rare case report from Syria

Suleiman,

Shbani

et al. 2023

Annals of Medicine &Amp; Surgery

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Introduction and Importance: Gallstone ileus is a rare and potentially life-threatening condition characterized by the obstruction of the small intestine due to a gallstone. It occurs as a complication of gallstone disease, where a large gallstone erodes through the gallbladder into the gastrointestinal tract, creating a fistula. Case presentation: A type 2 diabetic woman in her fifties presented to the emergency department complaining of abdominal pain and vomiting. She has not emptied her bowels since three days ago. A clinical examination showed tenderness in the abdomen associated with fecal vomiting. A CT scan was performed and showed a dilated gallbladder with gas. A giant gallstone in a small intestinal loop was observed. The diagnosis was a small intestinal obstruction due to a giant gallstone and a duodenal-biliary fistula. Clinical Discussion: Gallstone ileus is an occasional complication of cholelithiasis, occurring in less than 0.5% of patients. Gallstone ileus frequently occurs in the terminal ileum and the ileocecal valve. Regarding the clinical presentation, abdominal pain is the most common symptom, followed by vomiting, and constipation. CT scan is the gold standard utilized to diagnose gallstone ileus. Surgical intervention is the mainstay treatment for giant gallstone ileus, with enterolithotomy being the most commonly performed procedure. Conclusion: Gallstone ileus is an uncommon but potentially life-threatening condition that can emerge in elderly patients with a history of cholelithiasis. It is crucial for clinicians to maintain a high index of suspicion when encountering older patients with risk factors for cholelithiasis and intestinal obstruction.

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Obstrucción intestinal secundaria a íleo biliar: reporte de caso

Cited by 3 publications

References 4 publications

Gallstone ileus, controversies on current surgical management

Gallstone ileus, controversies on current surgical management

Gallstone as a cause of intestinal obstruction (Bouveret syndrome)

Small intestinal obstruction due to a giant gallstone: a rare case report from Syria

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