Uncommon and Unusual Gastrointestinal Causes of the Acute Abdomen: Computed Tomographic Diagnosis

Biliodigestive fistulae and gallstone ileus: diagnostic and therapeutic considerations. Our experience

“…But US is not so useful for the study of the fistula (15). CT-scan with contrast is the gold standard to allow the correct pre-operative diagnosis: it iden-tifies the three Rigler signs, when present, moreover it is able to identify the fistula thanks to the contrast (16,17). Surgical options include: a simple enterotomy with extraction of the calculus; the addiction of a cholecystectomy with fistula repair.…”

High small bowel obstruction from a gallstone

“…Hence, many of these patients undergo surgery without definitive diagnosis. Imaging modalities, such as plain abdominal films, ultrasound and CT scan may help identify the cause of the intestinal obstruction [3,[15][16][17]. In our case, before establishing ileus, the signs and symptoms of acute cholecystitis, abdominal imaging and a high index of suspicion helped us reach a definite diagnosis.…”

Comparative analysis of MDCT and MRI in diagnosing chronic gallstone perforation and ileus

“…In additional, MDCT could present the exact location of ectopic gallstone and the extent of SBO, also visualize other signs of the cholecystitis and pericholecystitis, gallbladder atrophy or augmentation with or without gallstone, edema and thickening of the gallbladder wall and the abnormality of intestine nearby. Evidently, MDCT was a rapid noninvasive technology in preoperatively diagnosing GSI with a sensitivity of 93%, 100% specificity and 99% accuracy [6], which could speed the early diagnosis and prompt treatment making, and reduce the morbidity and mortality of GSI [10][11][12][13][14]. In our study, it was also showed that MDCT could precisely visualize the extent of intestinal obstruction (100%), pneumobilia (100%) and location of the ectopic stone (88.5% (23/26)) respectively.…”