Open AccessGallstone ileus, clinical presentation, diagnostic and treatment approach
Author(s) -
Carlos M. Nuño-Guzmán,
María Eugenia Marín-Contreras,
Mauricio Figueroa-Sánchez,
Jorge Corona
Publication year - 2016
Publication title -
world journal of gastrointestinal surgery
Language(s) - English
Resource type - Journals
ISSN - 1948-9366
DOI - 10.4240/wjgs.v8.i1.65
Subject(s) - gallstone ileus , medicine , etiology , surgery , fistula , cholecystectomy , bowel obstruction , general surgery , presentation (obstetrics) , gallstones
Gallstone ileus is a mechanical intestinal obstruction due to gallstone impaction within the gastrointestinal tract. Less than 1% of cases of intestinal obstruction are derived from this etiology. The symptoms and signs of gallstone ileus are mostly nonspecific. This entity has been observed with a higher frequency among the elderly, the majority of which have concomitant medical illness. Cardiovascular, pulmonary, and metabolic diseases should be considered as they may affect the prognosis. Surgical relief of gastrointestinal obstruction remains the mainstay of operative treatment. The current surgical procedures are: (1) simple enterolithotomy; (2) enterolithotomy, cholecystectomy and fistula closure (one-stage procedure); and (3) enterolithotomy with cholecystectomy performed later (two-stage procedure). Bowel resection is necessary in certain cases after enterolithotomy is performed. Large prospective laparoscopic and endoscopic trials are expected.