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Gallstone obstruction in anastomotic stricture: A very rare case

Year 2015, Volume: 6 Issue: 1, - , 10.05.2015
https://doi.org/10.5799/ahinjs.01.2015.01.0490

Abstract

Gallstone ileus is a rare but serious complication of cholelithiasis. It is a rare cause of small bowel obstruction but it accounts up to 25% of non-strangulated small bowel obstructions in elderly. Obstruction usually occurs in the terminal ileum. Although the most frequent mechanism of gallstone ileus is migration of the gallstone through a gallbladder-duodenal fistula, there have been cases of bowel obstruction caused by gallstones without any findings of bilio-enteric fistula during the operation. The diagnosis is usually delayed due to nonspecific clinical signs and symptoms. Abdominal computerized tomography (CT) scan is the optimal way to diagnose the gallstone ileus. It can identify the site and nature of the obstruction. The optimal surgical approach is a matter of debate. Enterolithotomy is the most performed operation. One stage operation should be performed in selected low risk patients. In this study, we report a 55 years old male patient who underwent surgical intervention due to gallstone ileus. During the operation, we observed that two individual gallstones lead to obstruction in anastomotic stricture which was due to the patient’s prior small bowel resection. Also, no fistula was found during the operation between the gall bladder and the gastrointestinal tract of patient. The gallstones were removed by enterolithotomy. Because there was no gallstone in the gallbladder, we did not perform cholecystectomy. J Clin Exp Invest 2015; 6 (1): 72-74 Key words: Gallstone ileus, anastomotic stricture, bilioenteric fistula

References

  • Martin F. Intestinal obstruction due to gallstones. Ann
  • Surg 1912;55:725.
  • Ayantunde AA, Agrawal A. Gallstone Ileus: Diagnosis
  • and Management. World J Surg 2007;31:1292–1297.
  • Lassandro RS, Ragozzino A, et al. Role of helical CT
  • in diagnosis of gallstone ileus and related conditions.
  • AJR 2005;185:1159–1165.
  • Ravikumar R, Williams JG. The operative management
  • of gallstone ileus. Ann R Coll Surg Engl 2010;92:279–
  • -
  • Nakao A, Okamoto Y, Sunami M, et al. The oldest
  • patient with gallstone ileus: report of a case and review
  • of 176 cases in Japan. Kurumo Medical Journal
  • ;55:29-33.
  • Goyal A, Srivastava A. Gallstone ileus following endoscopic
  • retrograde cholangiopancreatography and
  • sphincterotomy: a case report. Journal of Medical
  • Case Reports 2008;2:342.
  • Yu CY, Lin CC, Shyu RY, et al. Value of CT in the diagnosis
  • and management of gallstone ileus. World J
  • Gastroenterol 2005;11:2142–2147.

Anastomoz darlığında safra taşı ileusu: Nadir bir vaka

Year 2015, Volume: 6 Issue: 1, - , 10.05.2015
https://doi.org/10.5799/ahinjs.01.2015.01.0490

Abstract

Safra taşı ileusu, kolelitiazis’in nadir ama ciddi bir komplikasyonudur. İnce barsak tıkanıklıklarının nadir bir nedeni olmasına rağmen, yaşlılarda strangulasyon’a bağlı olmayan ince barsak tıkanıklıklarının %25’inin sebebidir. Tıkanıklık, genellikle terminal ileum’da gerçekleşir. Safra taşı ileusu’nun en sık oluş mekanizması safra kesesi duodenum arasındaki bir fistülden safra taşının migrasyonu olsa da, ameliyat sırasında bilio-enterik fistül saptanamayan vakalar da rapor edilmiştir. Hastalığın tanısı, nonspesifik belirti ve bulgular nedeniyle genellikle gecikir. Safra taşı ileusu tanısını koymada abdominal bilgisayarlı tomografi ideal olan bir yöntemdir. Tıkanıklığın yerini ve özelliğini gösterebilir. En uygun cerrahi yöntem ise tartışmalıdır. Enterolitotomi en sık uygulanan yöntemdir. Tek aşamalı ameliyat ise, sadece seçilmiş düşük riskli hastalarda yapılmalıdır. Bu çalışmamızda, safra taşı ileusu nedeniyle ameliyat ettiğimiz 55 yaşındaki erkek bir hastayı sunuyoruz. Ameliyatta, 2 adet safra taşının hastanın daha önce geçirdiği ince barsak rezeksiyonundan sonra oluşan anastomoz darlığında tıkanıklığa neden olduğu saptandı. Ayrıca, hastanın safra kesesi ile gastrointestinal kanalı arasında fistülün olmadığı da saptandı. Enterolitotomi ile safra taşları çıkartıldı. Safra kesesinde taş saptanmadığı için, kolesistektomi yapılmadı

References

  • Martin F. Intestinal obstruction due to gallstones. Ann
  • Surg 1912;55:725.
  • Ayantunde AA, Agrawal A. Gallstone Ileus: Diagnosis
  • and Management. World J Surg 2007;31:1292–1297.
  • Lassandro RS, Ragozzino A, et al. Role of helical CT
  • in diagnosis of gallstone ileus and related conditions.
  • AJR 2005;185:1159–1165.
  • Ravikumar R, Williams JG. The operative management
  • of gallstone ileus. Ann R Coll Surg Engl 2010;92:279–
  • -
  • Nakao A, Okamoto Y, Sunami M, et al. The oldest
  • patient with gallstone ileus: report of a case and review
  • of 176 cases in Japan. Kurumo Medical Journal
  • ;55:29-33.
  • Goyal A, Srivastava A. Gallstone ileus following endoscopic
  • retrograde cholangiopancreatography and
  • sphincterotomy: a case report. Journal of Medical
  • Case Reports 2008;2:342.
  • Yu CY, Lin CC, Shyu RY, et al. Value of CT in the diagnosis
  • and management of gallstone ileus. World J
  • Gastroenterol 2005;11:2142–2147.
There are 21 citations in total.

Details

Primary Language English
Journal Section Case Report
Authors

Burak Ülger This is me

Ömer Uslukaya This is me

Abdullah Oğuz This is me

Ercan Gündüz This is me

Memik Teke This is me

Bilsel Baç This is me

Publication Date May 10, 2015
Published in Issue Year 2015 Volume: 6 Issue: 1

Cite

APA Ülger, B., Uslukaya, Ö., Oğuz, A., Gündüz, E., et al. (2015). Gallstone obstruction in anastomotic stricture: A very rare case. Journal of Clinical and Experimental Investigations, 6(1). https://doi.org/10.5799/ahinjs.01.2015.01.0490
AMA Ülger B, Uslukaya Ö, Oğuz A, Gündüz E, Teke M, Baç B. Gallstone obstruction in anastomotic stricture: A very rare case. J Clin Exp Invest. May 2015;6(1). doi:10.5799/ahinjs.01.2015.01.0490
Chicago Ülger, Burak, Ömer Uslukaya, Abdullah Oğuz, Ercan Gündüz, Memik Teke, and Bilsel Baç. “Gallstone Obstruction in Anastomotic Stricture: A Very Rare Case”. Journal of Clinical and Experimental Investigations 6, no. 1 (May 2015). https://doi.org/10.5799/ahinjs.01.2015.01.0490.
EndNote Ülger B, Uslukaya Ö, Oğuz A, Gündüz E, Teke M, Baç B (May 1, 2015) Gallstone obstruction in anastomotic stricture: A very rare case. Journal of Clinical and Experimental Investigations 6 1
IEEE B. Ülger, Ö. Uslukaya, A. Oğuz, E. Gündüz, M. Teke, and B. Baç, “Gallstone obstruction in anastomotic stricture: A very rare case”, J Clin Exp Invest, vol. 6, no. 1, 2015, doi: 10.5799/ahinjs.01.2015.01.0490.
ISNAD Ülger, Burak et al. “Gallstone Obstruction in Anastomotic Stricture: A Very Rare Case”. Journal of Clinical and Experimental Investigations 6/1 (May 2015). https://doi.org/10.5799/ahinjs.01.2015.01.0490.
JAMA Ülger B, Uslukaya Ö, Oğuz A, Gündüz E, Teke M, Baç B. Gallstone obstruction in anastomotic stricture: A very rare case. J Clin Exp Invest. 2015;6. doi:10.5799/ahinjs.01.2015.01.0490.
MLA Ülger, Burak et al. “Gallstone Obstruction in Anastomotic Stricture: A Very Rare Case”. Journal of Clinical and Experimental Investigations, vol. 6, no. 1, 2015, doi:10.5799/ahinjs.01.2015.01.0490.
Vancouver Ülger B, Uslukaya Ö, Oğuz A, Gündüz E, Teke M, Baç B. Gallstone obstruction in anastomotic stricture: A very rare case. J Clin Exp Invest. 2015;6(1).