Spontaneous resolution of gallstone ileus followed by imaging: A case report and a literature review

Brogna, Barbara; Ventola, Marta; Blasio, Roberta; Colucci, Lorenzo Junior; Gagliardi, Giuliano; Bignardi, Elio; Laporta, Antonietta; Iovine, Lorenzo; Volpe, Mena; Musto, Lanfranco

doi:10.1016/j.radcr.2022.12.023

Cited by 5 publications

(3 citation statements)

References 29 publications

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“…However, in this case, there was a potential 5 to 33% risk of the repeated impact of more stones. In this case, the clinicians opted for conservative management due to the high risk of surgical complications from the patient's older age and comorbidities [12,13].…”

Section: Discussionmentioning

confidence: 99%

“…The literature reports that, in cases of spontaneous resolution, the dimensions of gallstones vary from 2 to 6 cm. Brogna B, et al [12,13] found 13 previously published cases of biliary ilio (BI) with spontaneous resolution; in most cases, the patients were women. The time for spontaneous resolution varies from 16 hours to 7 days, and the impaction site was, in most cases, the right iliac fossa.…”

Section: Discussionmentioning

confidence: 99%

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Gallstone Ileus in a Woman - A Case Report

Alejandro Alberto,

Víctor Hugo,

Rubén

et al. 2023

Int J Surg Res Pract

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Introduction: Prevalence of GSD has been 10-20% in developed countries, 2.5-10% in African populations, and 3.1-6.1% in Asians. Approximately 3-8% of GSD patients experience complications, including cholecystitis, gallstone ileus, pancreatitis, empyema, and gallbladder perforation. Therefore, GSD care could be expensive and place a considerable burden on the budget of health systems.Case report: A 57-year-old female admitted to the emergency room due to oral intolerance and abdominal pain. In the ER, she presented abdominal distension, inability to pass bowel motions or gas, with the requirement of nasogastric tube placement, and discharge with intestinal characteristics was obtained, upon admission leukocytosis of 20,000 with neutrophilia. CT scan showed a stone of probable biliary origin impacted in the terminal ileum, pneumobilia, and uncomplicated diverticular disease. She was evaluated by general surgery, performing exploratory laparotomy with the following findings: Impacted gallstone at 20 cm from the ileocecal valve, distended small bowel loops, no evidence of ischemia, and scant peritoneal reaction fluid. Enterolithotomy was performed 30 cm from the ileocecal valve plus primary closure with Heineke-Mikulicz technique.Discussion: Gallstone ileus is a mechanical small bowel obstruction induced by an impacted ectopic gallstone. The terminal ileum and ileocecal valve are the most common sites of gallstone impaction. Generally, gallstones < 2-2.5 cm have a high probability of spontaneous transit. Gallstone ileus is a rare long-term complication of cholelithiasis. Risk factors include female gender, age > 65 years, history of episodes of untreated cholecystitis, and larger stones (> 2.5 cm).

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Gallstone Ileus in a Woman - A Case Report

Alejandro Alberto,

Víctor Hugo,

Rubén

et al. 2023

Int J Surg Res Pract

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“…Em síntese, o íleo biliar é uma condição rara, desafiadora no diagnóstico e requer abordagens cuidadosas. A escolha terapêutica varia nas diferentes literaturas, destacando a importância do estudo de casos para aprimorar o entendimento e a aplicação de condutas mais adequadas (2,5,6).…”

Section: Introductionunclassified

Íleo biliar em puérpera: um relato de caso

Carvalho,

Gandolfi,

Lima

et al. 2024

Braz. J. Hea. Rev.

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O íleo biliar é uma complicação incomum da colelitíase, caracterizada pela obstrução da luz entérica devido à presença de cálculos biliares, decorrente de uma comunicação anormal entre a via biliar e o tubo digestivo, no qual permite a migração de um cálculo biliar para a luz entérica. A doença, observado em menos de 0,5% dos pacientes com cálculos biliares, é mais prevalente em indivíduos acima de 70 anos, com maior incidência no sexo feminino. Cursa clinicamente com um quadro de obstrução intestinal, manifestando-se com dor abdominal, vômitos e distensão abdominal. A gravidez é um fator de risco significativo para a formação de cálculos de colesterol devido às alterações hormonais e fisiológicas. O diagnóstico é feito pela história clínica, exame físico e exames de imagem. Quanto ao tratamento, deve ser iminentemente cirúrgico e a ação reside na desobstrução intestinal, na correção da fístula e colecistectomia precoce devido aos elevados índices de morbidade e mortalidade. O presente artigo apresenta o caso de uma paciente do sexo feminino, com 35 anos de idade, submetida a cesariana havia 30 dias, com íleo biliar.

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