Direct X-ray and CT Findings of GallStone Ileus
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CASE REPORT
Direct X-ray and CT Findings of GallStone Ileus Saim Turkoglu 1 & Cemil Goya 1 & Tolga Kalayci 2 Received: 29 February 2020 / Accepted: 11 March 2020 # Association of Surgeons of India 2020
Abstract Gallstone ileus is a complication of biliary tree stones and was first described by Bartholin in 1654. In any localization, one or more gallstones may occlude as a result of access to the gastrointestinal tract via the bilioenteric fistula. In this article, we aimed to present a rare and operate with gallstone ileus cases of radiological and surgical imaging findings. A 74-year-old male patient presented with complaints of right upper quadrant pain, nausea, vomiting, and constipation in the last few days of the emergency department. Radiographical and computed tomography examination was done. The patient was urgently operated with gallstones. The ileal stone was removed in addition to cholecystectomy in the operation, and the cholecystododenal fistula detected during the operation was repaired. Gallstone ileus is an uncommon cause of a mechanical small bowel obstruction. Gallstone ileus should also be kept in mind in the elderly patients who have recurrent abdominal operation history with abdominal obesity findings of the omentum. In our case, we wanted to emphasize the importance of the radiological approach in diagnosing gallstone ileus disease in elderly patients with diabetes mellitus. Keywords Gallstone . İleus . Computed tomography . Enterotomy
Introduction and Objective Gallstone ileus is a complication of biliary tree stones and was first described by Bartholin in 1654 [1, 2]. One or more gallstones may become obstructed as a result of access to the gastrointestinal tract via bilioenteric fistula for any localization [3]. In this article, we aimed to present a rare and operate with gallstone ileus cases of radiological and surgical imaging findings.
Case Report A 74-year-old male patient presented with complaints of right upper quadrant pain, nausea, vomiting, and constipation in the * Saim Turkoglu [email protected] Cemil Goya [email protected] Tolga Kalayci [email protected] 1
Department of Radiology, MedicalFaculty, Yuzuncu Yıl University, 65100 Van, Turkey
2
Department of General Surgery, Iğdır Public Hospital, Iğdır, Turkey
last few days of the emergency department. Murphy’s sign was positive on physical examination. There were a high number of white cells in the laboratory evaluation. The acutephase CRP was 134 mg/l. There was a slight increase in direct and indirect bilirubin values in liver function tests. Radiographically, it was evaluated as significant air-fluid levels in the small intestine lupus, and in the right lower part of the abdomen, a superimposed 24-mm radiolucency with a slightly radiolucent target was observed at the distal ileal level (Fig. 1a). Ultrasonographic examination of the gallbladder showed collagenous echogenicity of the air in the main bile ducts, dilatation in the intestine compatible with ileus, and light-free fluid densities in the perihepa
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