Gallstone ileus after recent cholecystectomy. Case report and review of the literature

Segundo, Uriel Martínez; Sanchez, Anthony; Bernal, María Paulina Sesman; Burguete, A.

doi:10.1016/j.ijscr.2021.01.077

Cited by 3 publications

(16 citation statements)

References 32 publications

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“…Although gallstone Ileus (GSI) is a rare etiology of mechanical intestinal obstruction, its formation post-cholecystectomy is even rarer [4,8]. In 1951, the first case of GSI was reported 15 years post-cholecystectomy [9].…”

Section: Discussionmentioning

confidence: 99%

“…GSI is usually preceded by multiple episodes of acute or chronic cholecystitis. Pathophysiologically, multiple inflammatory episodes of the gallbladder with stone lead to adhesion formation with the surrounding structures such as the duodenum, causing mucosa inflammation, erosion, and ischaemia to the GB wall forming a fistula through which a stone may slip causing an obstruction [4,5]. The obstruction can occur at different gastrointestinal tract levels but more commonly at the terminal ileum and the ileocecal valve [5,8,9].…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, this pathology is extremely rare in post-cholecystectomy cases. Only a few cases of GSI after cholecystectomy are documented in the literature [2][3][4]. Typically, elderly women with a prolonged history of comorbidities are mostly affected [1].…”

Section: Introductionmentioning

confidence: 99%

“…Typically, elderly women with a prolonged history of comorbidities are mostly affected [1]. This condition is explained by various pathophysiological mechanisms ranging from adhesions, fistula formation, and diverticula phenomenon [4,5]. Clinical and epidemiological pictures of gallstone ileus (GSI) are elusive [6].…”

Section: Introductionmentioning

confidence: 99%

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Gallstone Ileus in the Absence of Gallbladder, Rare Etiology of Bowel Obstruction: A Case Report and Literature Review

Alenezi¹,

Alenezi²,

Saleem³

et al. 2023

AJSCR

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Background: Gallstone ileus post-cholecystectomy is extremely rare surgical emergency causing mechanical bowel obstruction. This condition is usually misdiagnosed due to its non-specific clinical features. Radiological investigations are essential to evaluate and diagnose gallstone ileus cases. Case Presentation: A 92-year-old female patient, cholecystomized, presented to our hospital with a one-week history of an acute confusional state, generalized abdominal pain, and vomiting. The physical examination showed a disoriented patient with a distended abdomen and generalized tenderness, especially in the epigastric area. Hyperactive bowel sounds were audible. Laboratory investigations were non-specific. A plain abdominal X-ray was insignificant. The abdominal ultrasound showed marked abdominal gaseous distention. Then, an abdominal CT scan was performed, revealing an impression of gallstone ileus causing small bowel obstruction with no evidence of fistula formation. So, surgical intervention was decided, and an 8-gram gallstone was exteriorized through an enterolithotomy. The postoperative period was uneventful. Discussion: Gallstone ileus is an unusual entity that often affects elderly females. The clinical features of gallstone ileus include abdominal pain, abdominal distension, nausea, and vomiting. Diagnosis of gallstone ileus relies on imaging and physical examination. Abdominal CT with contrast provides a definitive diagnostic tool. The surgical options to manage the gallstone ileus can be either one or two-staged enterolithotomy. Conclusion: Due to the rare etiologic origin of the gallstone ileus in post-cholecystectomy cases, we report the case of a 92-year-old female with an acute confusional state and generalized abdominal pain, found to be caused by detected gallstone ileus, lacking evidence of fistula formation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Gallstone Ileus in the Absence of Gallbladder, Rare Etiology of Bowel Obstruction: A Case Report and Literature Review

Alenezi¹,

Alenezi²,

Saleem³

et al. 2023

AJSCR

View full text Add to dashboard Cite

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“…GI more commonly occurs in the female and elderly (over 60-years-old) population but additional risk factors include a history of cholelithiasis, large stones (larger than 2 cm) and episodes of acute cholecystitis [ 3 , 6 ]. A diagnosis for GI is often delayed, and it is characterized by a high mortality rate [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Multiple gallstones causing ileus twenty years after cholecystectomy

Petrillo

Green

Haag

et al. 2022

Journal of Surgical Case Reports

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Gallstone ileus is an important form of small bowel obstruction that occurs in less than 0.5% of patients who present with obstruction. A biliary enteric fistula that evolves in the setting of chronic cholecystitis may allow the passage of a large gallstone into the gastrointestinal tract distal to the common duct. A single stone that is sufficient in size (at least 2–2.5 cm diameter) may then create a mechanical obstruction, most often at the ileocecal valve or the terminal ileum where the intestinal lumen narrows, and where peristalsis is less robust. We present an unusual case of gallstone ileus in a patient whose obstruction was caused by not one, but seven individual gallstones, collectively restricted in the jejunum at the point of a previous anastomosis and occurring twenty years after cholecystectomy.

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An unusual case of gallstone ileus 35 years post-cholecystectomy masked by an incisional hernia

Gordon,

Molina,

Diaz

et al. 2024

Journal of Surgical Case Reports

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Gallstone ileus is an uncommon cause of mechanical bowel obstruction in patients with cholecystitis and gallstones who develop a fistula over time. In the post-cholecystectomy patient, the presence of gallstone ileus is extremely rare; these patients have different pathophysiological pathways, such as a spilled gallstone that subsequently erodes into the bowel, subtotal cholecystectomies, and diverticulae that can hold a gallstone for hidden several years. In these patients, the clinical presentations are unique because of their rarity and because the gallbladder had been previously removed. A high index of suspicion by the medical team is needed for diagnosis. We present the case of an 85-year-old male who had a history of cholecystectomy 35 years ago. He presented to the emergency department with intestinal obstruction. Since he had a hernia, it was thought to be the cause of the obstruction; however, during surgery, we were surprised to find a gallstone ileus. After surgery, he fully recovered.

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Gallstone ileus after recent cholecystectomy. Case report and review of the literature

Cited by 3 publications

References 32 publications

Gallstone Ileus in the Absence of Gallbladder, Rare Etiology of Bowel Obstruction: A Case Report and Literature Review

Gallstone Ileus in the Absence of Gallbladder, Rare Etiology of Bowel Obstruction: A Case Report and Literature Review

Multiple gallstones causing ileus twenty years after cholecystectomy

An unusual case of gallstone ileus 35 years post-cholecystectomy masked by an incisional hernia

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