The Role of Magnetic Resonance Imaging in a Difficult Case of Gallstone Ileus

Tiong, Jonathan; Grant, Katharine; Shilton, Hamish

doi:10.7759/cureus.33038

Cited by 2 publications

(2 citation statements)

References 7 publications

(10 reference statements)

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“…However, some gallstones composed of cholesterol and bile salts are radiolucent, [22] in which case CT was not helpful for detecting stones. One case reported by Tiong et al [23] displayed symptoms of bowel obstruction; however, blood tests and imaging were not definitive. Although a secondary cholecystoduodenal fistula was suggested on CT, no stones were found within the small bowel and the transition points were not clearly defined.…”

Section: Discussionmentioning

confidence: 99%

The role of computed tomography in enterolith causing small bowel obstruction: A case series

Zhang,

Xie,

Liu

2023

Medicine

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Intestinal obstruction caused by enteroliths is an uncommon medical condition. Timely detection of the presence of enteroliths and identification of their origin can guide clinical treatment. This study aimed to present the Computed Tomography (CT) features of enterolithic ileus confirmed by surgery in 7 patients. Seven patients with surgically confirmed enterolithic ileus who were admitted to our hospital between December 2013 and December 2022 were continuously enrolled, and an abdominopelvic CT examination was performed before surgery. The imaging characteristics were then analyzed. In the transition zone of all patients with intestinal obstruction, the sharply defined intraluminal masses were found. Three of them had gallstones and 4 had primary enteroliths. All 5 enteroliths in the 4 patients with primary enteroliths were in the proximal small intestine and were low-density with gas. Additionally, 3 gallstones were present in the distal small bowel, and calcifications were observed. Simultaneously, cholecystitis and secondary cholecystoduodenal fistula were observed in all 3 patients with gallstones. Compared to gallstones, primary enteroliths tend to be higher positioned, less dense, and accompanied by gas. CT examination is very important, as it allows accurate identification, location, diagnosis, and identification of complications of the different types of enteroliths to provide a basis for surgery.

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Section: Discussionmentioning

confidence: 99%

The role of computed tomography in enterolith causing small bowel obstruction: A case series

Zhang,

Xie,

Liu

2023

Medicine

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“…Moreover, while gallstone ileus has been described in the literature, no reports of MRI in the acute setting being used for diagnostic purposes have been reported. Therefore, if there is a high index of suspicion for gallstone ileus, gallstone ileus warrants expedited MRI to confirm the diagnosis due to the urgency of management [8].…”

Section: Case Reportmentioning

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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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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The Role of Magnetic Resonance Imaging in a Difficult Case of Gallstone Ileus

Cited by 2 publications

References 7 publications

The role of computed tomography in enterolith causing small bowel obstruction: A case series

The role of computed tomography in enterolith causing small bowel obstruction: A case series

Gallstone Ileus in a Woman - A Case Report

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