TY  - JOUR
T1  - CLINICAL UTILITY OF RADIOLOGICAL IMAGING IN THE EVALUATION OF GALLSTONE ILEUS
TT  - Safra Taşı İleusu Değerlendirmesinde Radyolojik Görüntülemenin Klinik Faydası
AU  - Özdemir, Adnan
AU  - Yılmazsoy, Yunus
AU  - Arslan, Serdar
AU  - Pehlivanlı, Faruk
PY  - 2019
DA  - December
DO  - 10.24938/kutfd.590975
JF  - The Journal of Kırıkkale University Faculty of Medicine
JO  - Kırıkkale Uni Med J
PB  - Kırıkkale Üniversitesi
WT  - DergiPark
SN  - 2148-9645
SP  - 353
EP  - 358
VL  - 21
IS  - 3
LA  - en
AB  - Objective: Gallstone ileus is a rare complicationof cholelithiasis. It occurs as a result of the passage of bile stones intointestinal system via bilioenteric fistulae, which are formed by recurrentattacks of cholecystitis, and obstruction of the intestinal lumen. Theobjective of our study was to discuss the imaging findings of gallstone ileusamong patients diagnosed at our center.Material and Methods: Among patients that admitted to ourhospital’s radiology department between December 2016 and January 2019, themedical records of those with a history of gall bladder stone detected onultrasonography were retrospectively evaluated. Among those, cases of gallstoneileus were identified. Admission complaints, age, sex, comorbidities,radiological imaging findings, fistula localization, stone size, andobstruction level were recorded and analyzed.Results: Among 958 patients with bile stones, 342(35.7%) were male and 616 (64.3%) were female. Gallstone ileus was identifiedin five patients. Three of them were female (mean age 76.67± 13.05 years) and 2were male (meanage 59±1.41 years). Ileus signs were detected on plain radiograms forall patients. The gallbladders were not clearly visualized by ultrasonographyin any of patients with gallstone ileus. A diameter increase suggestive ofileus was detected in visualizable intestinal segments. Computed tomography toidentify the cause of ileus revealed air in the bile ducts, cholecystoduodenalfistula, stones in intestinal lumen, and an appearance consistent with ileusproximal to that segment. The mean size of the stones was 26.20±16.3 mm (16-55mm).Conclusion:Although gallstone ileus is a rare cause ofintestinal obstruction, it should be definitely remembered in the differentialdiagnosis in patients with advanced age and a history of cholelithiasis whopresent to the emergency department.
KW  - Gallstone ileus
KW  - cholelithiasis
KW  - bilioenteric fistula
KW  - computed tomography
N2  - Amaç: Safra taşıileusu kolelitiazisin nadir bir komplikasyonudur.Tekrarlayan kolesistit atakları sonucu gelişen kolesistoduodenal fistül yoluile safra kesesi taşının intestinal sisteme geçmesi sonucunda oluşur.Çalışmamızın amacı merkezimizde safra taşı ileusu tanısı alan hastalarıngörüntüleme bulgularını sunmaktır.Gereç ve Yöntemler: Aralık 2016-Ocak 2019 tarihleri arasında hastanemiz radyoloji birimine başvuran hastalardanultrasonografi tetkikinde safra kesesi taşı öyküsü olan hastaların dosyalarıretrospektif olarak incelendi. Bu hastalardan safra taşı ileusu tanısı alanhastalar tespit edildi. Hastaların hastaneye geliş şikayetleri, yaşları,cinsiyetleri, eşlik eden hastalıkları ve radyolojik görüntüleme bulguları ilefistül lokalizasyonu, taşın boyutu, obstrüksiyon seviyeleri değerlendirildi.Bulgular: Bilinen safrataşı öyküsü olan 342’si (%35.7) erkek, 616’sı (%64.3) kadın toplam 958 hastadansafra taşı ileusu tanısı alan 5 hasta tespit edildi. Hastaların 3’ü kadın (yaşortalaması 76.67±13.05/ yıl), 2’si erkek (yaş ortalaması 59±1.41 /yıl) idi. Hastalarındirekt grafilerinde ileus bulguları mevcuttu. Yapılan ultrasonografi tetkikindetüm hastalarda safra kesesi net olarak vizüalize edilemedi. Değerlendirilebilenbarsak segmentlerinde ileusu düşündürecek çap artışı tespit edildi. İleusnedenine yönelik yapılan bilgisayarlı tomografide hastaların hepsindeintrahepatik safra yollarında hava, kolesistoduedonal fistül, barsak lümenindetaşlar ve bu seviye proksimalinde ileus ile uyumlu görünüm izlendi. Taşlarınboyutları ortalama 26.2±16.3 mm (16-55 mm) idi.Sonuç: Safra taşı ileusu intestinal obstrüksiyonunnadir nedenlerinden biri olmakla birlikte intestinal obstrüksiyon bulguları ileacile başvuran ileri yaş ve kolelitiazisöyküsü olan hastalarda safra taşı ileusu mutlaka akla gelmelidir.
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UR  - https://doi.org/10.24938/kutfd.590975
L1  - https://dergipark.org.tr/tr/download/article-file/907208
ER  -