Jejunum-Biliary Intestinal Obstruction - Case Report

Nácul, Miguel Prestes

doi:10.26717/bjstr.2017.01.000497

Cited by 1 publication

(3 citation statements)

References 9 publications

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“…The morbimortality rates are elevated, as this disease affects mostly older patients with multiple comorbidities, and has frequently late diagnoses [4,7,11,12]. This condition is currently responsible for between 1% and 4% of all cases of mechanic bowel obstruction [2,3,7,11,13,14].…”

Section: Discussionmentioning

confidence: 99%

“…It is referred to be more common for fistulas to be found in the duodenum due to the proximity of both organs [1,9], although has been reported an incidence of only 3.5% [13]. They can also be found in the colon, mainly in hepatic angle (4.1%) [1,13], jejunum (16%) [13] and stomach (14.2%) [13].…”

Section: Discussionmentioning

confidence: 99%

“…The surgical treatment of the biliary ileum is usually done urgently, and it can be performed in one or two stages, depending on the clinical performance of the patient and the inflammation in the abdominal cavity. The enterolithotomy or enterolithotomy plus cholecystectomy and fistula repair are performed in the initial procedure (one stage), and the enterolithotomy with cholecystectomy only after the patient has recovered (two stages) [13]. The treatment aims to resolve the intestinal obstruction [9] with the removal of the gallstone through enterotomy followed by enterorrhaphy.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Cholecystoduodenal Fistula and Gallstone Ileus: A Case Report

Garritano¹,

Bl²,

Amt³

et al. 2019

J Surg Open Access

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The gallstone ileus is a serious complication of cholelithiasis due to the formation of a fistula from the gallbladder to the subjacent duodenum. The gallstones are usually large enough to cause intestinal obstruction. The distal ileum, close to the ileocecal valve, is the most common site of obstruction in these cases, where the luminal diameter is narrowed. This condition is currently responsible for 4% of all the cases of mechanical bowel obstruction. However, when considering a 65+ age group, the rate goes up to 25%. In conclusion, gallstone ileus is a surgical emergency that, although rare, has high morbimortality rates. We present the case of a patient with an acute abdomen who did not respond to verbal stimuli, with a previous history of gallstone cholecystitis and significant weight loss. The diagnosis was based on anamnesis, physical examination and complementary exams, particularly in imaging exams. Exploratory laparotomy was performed with enterotomy, the removal of the gallstones and enterorrhaphy, without manipulation of the gallbladder or cholecystoduodenal fistula. The postoperative evolution was satisfactory without complications. The patient received hospital discharge in good clinical conditions, with the recommendation to stay in outpatient follow-up.

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