Bowel Obstruction Due to Large Gallstone—Gallstone Ileus: Case Report

Abstract

Gallstone ileus is an unusual and peculiar complication of biliary lithiasis. Less than 1% of gallstones migrate into the gut, causing 25% of non-strangulated small bowell obstructions in elderly population. Diagnosis is difficult, leading to late operation. Considering the median age of the patients and the fact that in most cases surgery is delayed, there is a lot of dispute regarding the best approach. Recent technical facilities in diagnostic and surgical practice seem to be irrelevant for the general outcome. We report a case of a wonan, 70 years-old, diabetic with old history of gallbladder cancer (old abdominal scan 2 years ago). She was admitted to hospital for after 3 days of worsening abdominal pain and subboclusion. The scanner showed an occlusion on an ileal discrepancy with parietal calcifications. The gallblader was unseen. Particular elements suggesting the ethiology were absent. The surgical exploration: very large gallstones occluding the ileon. Enterolithotomy was practiced with gallstone extraction and suture. The cholecystectomy was impossible cause the hepatic mass. The patient died two days later because of pulmonary embolism.