International Journal of Medical Imaging

| Peer-Reviewed |

Gallstone Ileus: An Uncommon Cause of Acute Abdomen

Received: 05 March 2019    Accepted: 26 April 2019    Published: 17 May 2019
Views:       Downloads:

Share This Article

Abstract

Gallstone ileus is a rare cause of acute abdomen, representing less than 1% of intestinal obstruction. It is due to mechanical small bowel obstruction (SBO) by a migrated gallstone. we report this observation to illustrate the imaging findings especially in CT scan. A 62-year-old woman was admitted to emergency for acute bowel obstruction. The CT scan has confirmed jejunal bowel distension with fluid levels upstream endoluminal formation which was rounded and well limited, measuring 5 cm of long axis. This training was slightly hyperdense with hypodense areas of fat density. Moreover, there was aerobilia with multiple fistulas between the duodenum (D1) and gallbladder, which was empty. The triad of aerobilia, small bowel obstruction and migrant gallstone was suggestive of gallstone ileus diagnosis. The patient was operated with good evolution. Gallstone ileus is an uncommon presentation of gallstone disease. It is frequently observed in elderly patients with a history of cholelithiasis or cholecystitis. Early diagnosis is crucial and would avoid morbidity and mortality related to this disease. CT scan shows the classical triad of Rigler with pneumobilia, an ectopic stone and mechanical ileus. CT may improve the diagnosis providing important information regarding the exact number, size, and location of ectopic stones and the site of intestinal obstruction or direct visualization of a biliary–enteric fistula, to help clinicians in the therapeutic management of patients.

DOI 10.11648/j.ijmi.20190701.14
Published in International Journal of Medical Imaging (Volume 7, Issue 1, March 2019)
Page(s) 25-28
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Gallstone, Ileus, Bowel Obstruction, Pneumobilia, Acute Abdomen, CT Scan

References
[1] Liisa Chang, Minna Chang, Hanna M. Chang, Aina I. Chang, Fuju Chang. Clinical and radiological diagnosis of gallstone ileus: a mini review. Emerg Radiol (2018) 25:189–196
[2] Halabi WJ, Kang CY, Ketana N, Lafaro KJ, Nguyen VQ, Stamos MJ, Imagawa DK, Demirjian AN Surgery for gallstone ileus: a nationwide comparison of trends and outcomes. Ann Surg (2014) 259(2):329–335.
[3] Bass G, Gilani SN, Walsh TN Validating the 5Fs mnemonic for cholelithiasis: time to include family history. Postgrad Med J (2013) 89(1057):638–641.
[4] Farrell I, Turner P. A simple case of gallstone ileus? J Surg Case Rep 2015: rju148.
[5] Ploneda-Valencia CF, Gallo-Morales M, Rinchon C, Navarro-Muñiz E, Bautista-López CA, de la Cerda-Trujillo LF et al Gallstone ileus: an overview of the literature. Rev Gastroenterol (2017) Mex 82(3):248–254.
[6] Dai XZ, Li GQ, Zhang F, Wang XH, Zhang CY. Gallstone ileus: case report and literature review. World J Gastroenterol (2013) 19(33):5586–5589.
[7] Howells L, Liasis L, Demosthenous M. Gallstone coleus: a rare relation of gallstone ileus. Int J Surg Res (2016) 2(4):28–31.
[8] Mallipeddi MK, Pappas TN, Shapiro ML, Scarborough JE. Gallstone ileus: revisiting surgical outcomes using National Surgical Quality Improvement Program data. J Surg Res (2013)184(1): 84–88.
[9] Martín-Pérez J, Delgado-Plasencia L, Bravo-Gutiérrez A, Burillo-Putze G, Martínez-Riera A, Alarcó-Hernández A, Medina-Arana V. Gallstone ileus as a cause of acute abdomen. Importance of early diagnosis for surgical treatment. Cir Esp 9 (2013) 1(8):485–489.
[10] Nuño-Guzmán CM, Marín-Contreras ME, Figueroa-Sánchez M, Corona JL. Gallstone ileus, clinical presentation, diagnostic and treatment approach. World J Gastrointest Surg (2016) 8(1):65–76.
[11] Rigler L. G., Borman C. N., Noble J. F.: Gallstone obstruction: pathogenesis and roentgen manifestations. JAMA, 1941, 117: 1753-1759.
[12] Chou J.-W., Hsu C.-H., Liao K.-F., et al.: Gallstone ileus: Report of two cases and review of the literature. World J Gastroenterol, 2007, 13: 1295-1298.
[13] Swift SE, Spencer JA. Gallstone ileus: CT findings. Clin Radiol (1998) 53(6):451–454.
[14] Liang X, Li W, Zhao B, Zhang L, Cheng Y (2015) Comparative analysis of MDCT and MRI in diagnosing chronic gallstone perforation and ileus. Eur J Radiol 84(10):1835–1842.
[15] Furukawa A, Yamasaki M, Furuichi K, Yokoyama K, Nagata T, Takahashi M, Murata K, Sakamoto T. Helical CT in the diagnosis of small bowel obstruction. Radiographics (2001) 21(2):341–355.
[16] Barakos JA, Ralls PW, Lapin SA, Johnson MB, Radin DR, Colletti PM, Boswell WD Jr, Halls JM Cholelithiasis: evaluation with CT. Radiology (1987) 162(2):415–418.
[17] Yu C. Y., Lin C. C., Shyu R. Y., et al.: Value of CT in the diagnosis and management of gallstone ileus. World J Gastroenterol, 2005, 11: 2142- 2147
[18] Ihara E., Ochiai T., Yamamoto K., et al.: A case of gallstone ileus with a spontaneous evacuation. Am J Gastro -enterol, 2002, 97: 1259-1260.
[19] Lobo D. N., Jobling J. C., Balfour T. W.: Gallstone ileus: diagnostic pitfalls and therapeutic successes. J Clin Gastroenterol, 2000, 30: 72-76.
Author Information
  • Department of Radiology, Military Hospital, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech, Morocco

  • Department of Radiology, Military Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco

  • Department of Radiology, Military Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco

  • Department of Radiology, Military Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco

  • Department of Radiology, Military Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco

  • Department of Radiology, Military Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco

Cite This Article
  • APA Style

    Rachida Saouab, Fatima Zahra Rhouni, Mohammed Mahi, Hassan Boumdien, Touriya Amil, et al. (2019). Gallstone Ileus: An Uncommon Cause of Acute Abdomen. International Journal of Medical Imaging, 7(1), 25-28. https://doi.org/10.11648/j.ijmi.20190701.14

    Copy | Download

    ACS Style

    Rachida Saouab; Fatima Zahra Rhouni; Mohammed Mahi; Hassan Boumdien; Touriya Amil, et al. Gallstone Ileus: An Uncommon Cause of Acute Abdomen. Int. J. Med. Imaging 2019, 7(1), 25-28. doi: 10.11648/j.ijmi.20190701.14

    Copy | Download

    AMA Style

    Rachida Saouab, Fatima Zahra Rhouni, Mohammed Mahi, Hassan Boumdien, Touriya Amil, et al. Gallstone Ileus: An Uncommon Cause of Acute Abdomen. Int J Med Imaging. 2019;7(1):25-28. doi: 10.11648/j.ijmi.20190701.14

    Copy | Download

  • @article{10.11648/j.ijmi.20190701.14,
      author = {Rachida Saouab and Fatima Zahra Rhouni and Mohammed Mahi and Hassan Boumdien and Touriya Amil and Jamal El Fenni},
      title = {Gallstone Ileus: An Uncommon Cause of Acute Abdomen},
      journal = {International Journal of Medical Imaging},
      volume = {7},
      number = {1},
      pages = {25-28},
      doi = {10.11648/j.ijmi.20190701.14},
      url = {https://doi.org/10.11648/j.ijmi.20190701.14},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ijmi.20190701.14},
      abstract = {Gallstone ileus is a rare cause of acute abdomen, representing less than 1% of intestinal obstruction. It is due to mechanical small bowel obstruction (SBO) by a migrated gallstone. we report this observation to illustrate the imaging findings especially in CT scan. A 62-year-old woman was admitted to emergency for acute bowel obstruction. The CT scan has confirmed jejunal bowel distension with fluid levels upstream endoluminal formation which was rounded and well limited, measuring 5 cm of long axis. This training was slightly hyperdense with hypodense areas of fat density. Moreover, there was aerobilia with multiple fistulas between the duodenum (D1) and gallbladder, which was empty. The triad of aerobilia, small bowel obstruction and migrant gallstone was suggestive of gallstone ileus diagnosis. The patient was operated with good evolution. Gallstone ileus is an uncommon presentation of gallstone disease. It is frequently observed in elderly patients with a history of cholelithiasis or cholecystitis. Early diagnosis is crucial and would avoid morbidity and mortality related to this disease. CT scan shows the classical triad of Rigler with pneumobilia, an ectopic stone and mechanical ileus. CT may improve the diagnosis providing important information regarding the exact number, size, and location of ectopic stones and the site of intestinal obstruction or direct visualization of a biliary–enteric fistula, to help clinicians in the therapeutic management of patients.},
     year = {2019}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Gallstone Ileus: An Uncommon Cause of Acute Abdomen
    AU  - Rachida Saouab
    AU  - Fatima Zahra Rhouni
    AU  - Mohammed Mahi
    AU  - Hassan Boumdien
    AU  - Touriya Amil
    AU  - Jamal El Fenni
    Y1  - 2019/05/17
    PY  - 2019
    N1  - https://doi.org/10.11648/j.ijmi.20190701.14
    DO  - 10.11648/j.ijmi.20190701.14
    T2  - International Journal of Medical Imaging
    JF  - International Journal of Medical Imaging
    JO  - International Journal of Medical Imaging
    SP  - 25
    EP  - 28
    PB  - Science Publishing Group
    SN  - 2330-832X
    UR  - https://doi.org/10.11648/j.ijmi.20190701.14
    AB  - Gallstone ileus is a rare cause of acute abdomen, representing less than 1% of intestinal obstruction. It is due to mechanical small bowel obstruction (SBO) by a migrated gallstone. we report this observation to illustrate the imaging findings especially in CT scan. A 62-year-old woman was admitted to emergency for acute bowel obstruction. The CT scan has confirmed jejunal bowel distension with fluid levels upstream endoluminal formation which was rounded and well limited, measuring 5 cm of long axis. This training was slightly hyperdense with hypodense areas of fat density. Moreover, there was aerobilia with multiple fistulas between the duodenum (D1) and gallbladder, which was empty. The triad of aerobilia, small bowel obstruction and migrant gallstone was suggestive of gallstone ileus diagnosis. The patient was operated with good evolution. Gallstone ileus is an uncommon presentation of gallstone disease. It is frequently observed in elderly patients with a history of cholelithiasis or cholecystitis. Early diagnosis is crucial and would avoid morbidity and mortality related to this disease. CT scan shows the classical triad of Rigler with pneumobilia, an ectopic stone and mechanical ileus. CT may improve the diagnosis providing important information regarding the exact number, size, and location of ectopic stones and the site of intestinal obstruction or direct visualization of a biliary–enteric fistula, to help clinicians in the therapeutic management of patients.
    VL  - 7
    IS  - 1
    ER  - 

    Copy | Download

  • Sections