From Surf Wiki (app.surf) — the open knowledge base

Gallstone ileus

Field	Value
name	Gallstone ileus
synonyms	Biliary ileus
field	gastroenterology

Gallstone ileus is a rare form of small bowel obstruction caused by an impaction of a gallstone within the lumen of the small intestine. Such a gallstone enters the bowel via a cholecysto-enteric fistula. The presence of large stones, 2.5 cm in diameter, within the gallbladder are thought to predispose to fistula formation by gradual erosion through the gallbladder fundus. Once a fistula has formed, a stone may travel from the gallbladder into the bowel and become lodged almost anywhere along the gastrointestinal tract. Obstruction occurs most commonly at the near the distal ileum, within 60 cm proximally to the ileocecal valve. Rarely, gallstone ileus may recur if the underlying fistula is not treated.

First described by Thomas Bartholin in 1654, the name "gallstone ileus" is a misnomer because an ileus is, by definition, a non-mechanical bowel motility failure (as opposed to a mechanical obstruction by a stone).

Diagnosis

Diagnosis of gallstone ileus requires radiographic studies. Classic radiographic findings are known as Rigler's triad:

pneumobilia (air within the biliary tree)
evidence of small bowel obstruction
radiopaque gallstone on abdominal radiograph

Treatment

Initial management involves fluid resuscitation and potentially nasogastric suctioning. Since gallstone ileus constitutes a form of mechanical small bowel obstruction, it can be a surgical emergency and requires open or laparoscopic surgery to remove an impacted stone. The different strategies for surgical management are either enterolithotomy alone, allowing a delayed cholecystectomy after an inflammation-free period of 4–6 weeks (and therefore two-stage surgery) or enterolithotomy in combination with a cholecystectomy and fistula division (one-stage surgery). The different strategies for surgical management are controversial, and depend on factors such as patient fitness for surgery and comorbidities.

Eponym

Bouveret's syndrome refers to reverse gallstone ileus where the gallstone propagates proximally and causes gastric outlet obstruction by being impacted in first part of duodenum.

References

(2009). "Recurrent gallstone ileus: time to change our surgery?". Journal of Digestive Diseases.
(2015). "Harrison's Principles of Internal Medicine". McGraw-Hill.
"Gallstone Ileus".
"Rigler's Triad".

Info: Wikipedia Source

This article was imported from Wikipedia and is available under the Creative Commons Attribution-ShareAlike 4.0 License. Content has been adapted to SurfDoc format. Original contributors can be found on the article history page.

gastrointestinal-tract-disorders

Want to explore this topic further?

Ask Mako anything about Gallstone ileus — get instant answers, deeper analysis, and related topics.

Research with Mako

Free with your Surf account

Content sourced from Wikipedia, available under CC BY-SA 4.0.

This content may have been generated or modified by AI. CloudSurf Software LLC is not responsible for the accuracy, completeness, or reliability of AI-generated content. Always verify important information from primary sources.

Report