Spontaneous Resolution of Gallstone Ileus with Giant Stone: A Case Report and Literature Review

Giorgi, Alfredo De; Caranti, Alberto; Moro, Federico; Parisi, Claudia; Molino, Christian; Fabbian, Fabio; Manfredini, Roberto

doi:10.1111/jgs.13635

Cited by 15 publications

(22 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A retrospective study showed EF and BR were independently associated with higher mortality than ES, on multivariate analysis . And enterotomy with stone extraction remains the most popular surgical option; however, consistent with our case, there are some reports of spontaneous resolution of gallstone ileus, with patients passing the stones through the rectum, although there is no clear indicator of whether spontaneous evacuation of gallstones can be expected. Recurrence of gallstone ileus occurs in 5% of cases, with 85% within 6 months of the initial episode …”

Section: Discussionsupporting

confidence: 72%

Gallstone ileus with spontaneous evacuation: A case report

Takahashi

Kashimura

Konno

et al. 2018

J of Gen and Family Med

View full text Add to dashboard Cite

A 65‐year‐old man was referred to our hospital for abdominal pain. He had a history of enterotomy with stone extraction for gallstone ileus. On abdominal computed tomography, a stone measuring 32 × 28 mm lodged in the jejunum was identified. He was diagnosed with gallstone ileus and treated using a nasal ileus tube. Four days after admission, computed tomography showed that the stone had passed into the rectum. The gallstone was spontaneously evacuated on the same day. A fistula with the gallbladder was found in the duodenal bulb. The patient's condition improved, and he was discharged 9 days after admission.

show abstract

Section: Discussionsupporting

confidence: 72%

Gallstone ileus with spontaneous evacuation: A case report

Takahashi

Kashimura

Konno

et al. 2018

J of Gen and Family Med

View full text Add to dashboard Cite

show abstract

“…Another possible explanation is that conservative treatment may be chosen more frequently than before. Indeed, recent reports suggest the majority of cases now undergo spontaneous stone evacuation or endoscopic treatment [5][6][7][8][9] . The precise diagnosis of gallstone ileus using modern diagnostic radiology might have accelerated this trend.…”

Section: Discussionmentioning

confidence: 99%

“…The precise diagnosis of gallstone ileus using modern diagnostic radiology might have accelerated this trend. Besides, conservative management to avoid surgery is preferred, especially in older patients who often have severe comorbidities 8) . In our patient, gallstone ileus was accompanied by severe dehydration, acute renal failure, and enteritis.…”

Section: Discussionmentioning

confidence: 99%

“…Surgical intervention has been considered the mainstay of treatment, although the addition of cholecystectomy to the emergency enterolithotomy (removal of the stone after enterotomy) at the initial operation is controversial [2][3][4] . Alternatively, conservative therapy can be chosen because spontaneous resolution of gallstone ileus or successful endoscopic treatment has been increasingly reported [5][6][7][8][9] . If conservative treatment is highly effective, it would be attractive, since older patients often have severe comorbid disease which compromises the postop-erative course 8) .…”

Section: Introductionmentioning

confidence: 99%

“…Alternatively, conservative therapy can be chosen because spontaneous resolution of gallstone ileus or successful endoscopic treatment has been increasingly reported [5][6][7][8][9] . If conservative treatment is highly effective, it would be attractive, since older patients often have severe comorbid disease which compromises the postop-erative course 8) . However, the exact prediction of spontaneous evacuation of gallstones remains difficult.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Lessons learnt from a case of enterolithotomy for gallstone ileus of the jejunum

Kanagawa¹,

Maeda

Ishikawa³

et al. 2017

Ann. Cancer Res. Therap.

View full text Add to dashboard Cite

Background: Gallstone impaction, which is the result of gallstone migration into the digestive tract through a biliaryenteric fistula, is a well-known but rare cause of mechanical ileus. In this report, we describe an interesting case of gallstone ileus, in which surgical intervention was eventually necessary due to a delay in stone evacuation, and spontaneous closure of the biliary-enteric fistula occurred early after enterolithotomy. Case presentation: A 61-year-old woman was referred to our hospital for the treatment of vomiting. Computed tomography revealed a distended upper gastrointestinal tract, pneumobilia, and impaction with an oval mass measuring 3.2 × 2.5 cm in size within the intestinal lumen, leading to a diagnosis of gallstone ileus. The patient was initially treated conservatively with volume resuscitation, continuous hemodialysis for acute renal failure, and an ileus tube. Although the patient's condition improved, evacuation of the stone was not observed 5 days after admission. The patient then underwent enterolithotomy and the initial diagnosis was confirmed surgically. The postoperative course was uneventful and follow-up endoscopy revealed spontaneous closure of the biliary-enteric fistula. Conclusion: Spontaneous resolution of gallstone ileus after conservative treatment has been increasingly reported. However, our experience suggests that swift transition to surgical intervention is necessary when conservative treatment is not effective. Although spontaneous closure of the fistula may occur early after enterolithotomy, long term result, including cancer development, remains unknown.

show abstract

Colonic gallstone ileus treated by a transanal ileus tube followed by spontaneous gallstone dislodgement: A case report

Takagi¹,

Kinoshita²,

Kawaguchi³

et al. 2022

DEN Open

View full text Add to dashboard Cite

A 71‐year‐old obese woman was referred to our hospital with lower left abdominal pain. Computed tomography showed a 46 mm elliptic calcification lodged in the sigmoid‐descending colon junction (SDJ), which had been detected 5 years prior but was not within the gall bladder at presentation. Therefore, we diagnosed colonic gallstone ileus with obstructive colitis caused by a gallstone. Colonoscopy revealed a smooth gallstone impacted at the sigmoid‐descending colon junction, which was not fixed and could be pushed proximally with the endoscope. Dislodgement of the stone was unsuccessful with both a large polypectomy snare and a retrieval basket. Considering the high risk of surgery, we chose a non‐surgical treatment strategy for obstructive colitis. Accordingly, a transanal ileus tube was placed to drain the proximal portion of the gallstone. The drainage of the colon by the ileus tube was satisfactory; the proximal colon was decompressed, ameliorating the obstructive colitis. Five days after tube placement, a colonoscopy revealed spontaneous passage of the gallstone into the rectum where it was finally removed. Cholecystocolonic fistula formation was confirmed by magnetic resonance imaging. We decided to surgically close the cholecystocolonic fistula to prevent future retrograde biliary infections. The surgery used a surgical stapler and was successful, with an uneventful postoperative course. Since radical surgical treatment of colonic gallstones and cholecystoenteric fistulas has a risk of postoperative morbidity and mortality, this case illustrates the importance of thoroughly considering nonsurgical interventions and surgeries for the safe treatment of colonic gallstone ileus.

show abstract

Spontaneous Resolution of Gallstone Ileus with Giant Stone: A Case Report and Literature Review

Cited by 15 publications

References 7 publications

Gallstone ileus with spontaneous evacuation: A case report

Gallstone ileus with spontaneous evacuation: A case report

Lessons learnt from a case of enterolithotomy for gallstone ileus of the jejunum

Colonic gallstone ileus treated by a transanal ileus tube followed by spontaneous gallstone dislodgement: A case report

Contact Info

Product

Resources

About