Case 2
History:
65 year old female with history of gallstone presenting with acute abdominal pain.
Findings:
Abdominal CT showing dilated fluid-filled small bowel loops with a single oval shaped, intra-luminal stone, measuring 2.5 cm in diameter, with a calcfied rim. Note the presence of air in the gallbladder and biliary tree indicative of a bilioenteric fistula.
Diagnosis:
Gallstone ileus
Discussion:
Gallstone ileus is a complication in about 0.3 – 0.5 percent of all cases of cholelithiasis. The obstructing stone usually originates in the gallbladder, although some cases of gallstone ileus in which the gallbladder was absent have been described in the past. Gallstone ileus is more common in the elderly population.
References:
- Reisner R, Cohen J. Gallstone ileus: A review of 1001 reported cases. Am Surg.1994;60:441-446.
- Rigler LJ, Borman CN, Noble JF. Gallstone obstruction. Pathogenesis and roentgen manifestations. JAMA.1941;117:1753-1759.
- Seal EC, Creagh MF, Finch PJ. Gallstone ileus: A new role for abdominal computed tomography. Post Graduate Med J.1995:71:331-315.
