Currently, gallstone ileus is an unusual complication of cholelithiasis (0.3–3.0 %) and a rare cause of mechanical bowel obstruction (0.1–4.0 %). The rarity of the condition makes it impossible to plan the large prospective randomized clinical trials, so the analysis of case reports is significant for decision making in the management of gallstone ileus. We report a case of gallstone ileus in a middle-aged male who had a history of surgery for duodenal ulcer perforation in past. A combination of peptic ulcer disease and cholelithiasis is based on a reduced gastrointestinal hormones secretion. Clinical specialists need to consider information about the greater frequency and asymptomatic clinical course of gallstone disease against a background of duodenal ulcer. Duodenal ulcer scar and bulbar deformity may promote to the cholecystoduodenal fistula formation. In the presence of an acute bowel obstruction symptoms and the absence of gallbladder instrumental examination results, it is possible to recommend the prior gastroduodenoscopy for the pre-operative pneumobilia detection. The optimal surgical approaches for acute gallstone ileus are still controversial.
The paper compared the results of surgical treatment of patients with acquired aortic valve disease using classical sternotomy (54 patients) and mini-J sternotomy (35 patients). There has been a gradual increase in the use of minimally invasive approaches in comparison with traditional approaches for aortic valve replacement. The advantages of using ministernotomy access in terms of faster recovery in the postoperative period and improving the patient’s quality of life in the long term after surgery are shown. The use of mini-accesses for the treatment of patients with cardiovascular pathology is a promising and safe direction.
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