Introduction Gallstone Ileus is a rare complication of cholelithiasis, associated with multiple episodes of cholecystitis, with the formation of adhesions and fistulas between the gallbladder and adjacent organs. Its diagnosis is difficult, requiring complementary imaging tests such as computed tomography or radiography. Presentation of case Female patient, with intestinal obstruction for 7 days, associated with abdominal pain and previous episodes of pain in the right hypochondrium for 3 months. Abdominal CT scan identified aerobilia, gallstone impacted in the ileocecal valve and small loop dilatation, in addition to a probable cholecystogastric fistula. Opted for exploratory laparotomy, enterolithotomy and fistula correction in one surgical time. Discussion Gallstone ileus is rare among the complications of cholelithiasis, in addition to the fact that cholecystogastric fistula is associated with gastric pylorus obstruction and not impaction on the ileocecal valve. Imaging tests are useful to complement the diagnosis, and if Rigler's triad is present, the suspicion of gallstone ileus is increased. The presence of fistula between the gallbladder and stomach presents a frequency between 0 and 13.3%. There is no gold standard treatment for gallstone ileus, but surgery options for each type of patient and severity level. Conclusion There is no definitive protocol for optimal surgical treatment for biliary ileus, but the possibility of enterolithotomy associated with cholecystectomy and fistula correction can be evaluated in selected patients.
Introduction Paget-von Schroetter Syndrome is a rare condition, which refers to primary venous thrombosis of the subclavian-axillary bed. It is related to vigorous activities involving the upper limbs, presenting pain, edema and muscle swelling. Its diagnosis involves, besides the clinical suspicion, Doppler ultrasonography and should be performed early to ensure immediate treatment. The therapy is initially made with anticoagulation, but thrombolysis, decompression surgery, venolysis and venoplasty should be considered, which can lead to a better prognosis and lower risk of complications. Case report This article refers to a report of a male patient, with a history of physical activity, who developed thrombosis in the left upper limb and evolved, after anticoagulant treatment, to post-thrombotic syndrome. Discussion Paget-von Schroetter syndrome can be asymptomatic, but common features include hyperemia, edema, heaviness and pain in the affected arm, usually 24 h after the initial event and may be accompanied by low fever. In diagnostic investigation, imaging exam is essential. Early diagnosis of the syndrome allows the early start of treatment, leading to better results and prognosis. Conclusion Therefore, this study has the goal of making the diagnosis more effective and improves the clinical-surgical management, from the increase in the level of medical professionals' suspicion regarding the disease.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.