ISSN: 2149-2247 | E-ISSN: 2149-2549

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Gallstone Ileus Due to a Cholecystoduodenal Fistula [Erciyes Med J]
Erciyes Med J. 2019; 41(4): 450-452 | DOI: 10.14744/etd.2019.54926

Gallstone Ileus Due to a Cholecystoduodenal Fistula

Daniel Kostov, Vasil Kostov
Department of Surgery, Naval Hospital, Military Medical Academy, Varna, Bulgaria

Gallstone ileus is an infrequent complication of cholelithiasis, which manifests as small distended intestinal loops containing the characteristic radiographic patters of ďair-fluid levels.Ē Cholelithiasis is associated with high rates of morbidity and mortality. A 64-year-old woman was admitted to the hospital with a history of abdominal pain, nausea, multiple episodes of bilious vomiting, distention, and constipation that had been occurring continuously since the past 7 days. Clinical examination revealed bloating and diffused tenderness in the abdomen. There was no rebound and no defense. Computed Tomography (CT) of the abdomen showed air-fluid levels in small bowel segments, a 50◊35 mm calcified gallstone that was obstructing the terminal ileum, air in the gallbladder, and a large impacted ileal gallstone. The patient underwent laparoscopic repair of a cholecystoduodenal fistula, cholecystectomy, and removal of a gallstone by enterotomy with subsequent reconstruction of the terminal ileum. The patient was discharged on the 5th postoperative day with a full resolution of symptoms and no complications. CT of the abdomen is a useful aid in the diagnosis of cholecystoduodenal fistula and gallstone ileus. If the patientís medical condition is stable and suitable, a one-stage laparoscopic approach with concurring enterotomy, cholecystectomy, and fistula resection is a worthwhile endeavor.

Keywords: Gallstone ileus, cholecystoduodenal fistula, Bouveretís syndrome.

Daniel Kostov, Vasil Kostov. Gallstone Ileus Due to a Cholecystoduodenal Fistula. Erciyes Med J. 2019; 41(4): 450-452

Corresponding Author: Daniel Kostov, Bulgaria
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