Year 2022 / Volume 114 / Number 12
Letter
Successful gallstone ileus treatment by endoscopy

754-755

DOI: 10.17235/reed.2022.8898/2022

Andrea Guerro Moya, Ignacio Couto Wörner, Pedro Antonio Alonso Aguirre,

Abstract
We present the case of a 73-year-old woman who was admitted to hospital with a 6-day history of complete constipation, abdominal pain and vomiting. An abdominal CT scan is performed that shows a large colonic dilatation. In the sigmoid colon identifying a 43x20mm gallstone impaction and a solution of continuity between the gallbladder and the hepatic flexure with pneumobilia associated. Because the obstruction is located at the sigmoid colon, it was decided to perform an urgent colonoscopy. During the endoscopy, the gallstone was observed, which was successfully extracted using a Roth Net. The surrounding mucosa showed signs of mucosal damage and an extensive decubitus ulcer. After endoscopy, the patient presented resolution of the obstructive condition. During her admission, surgery was performed to resection the cholecystocolic fistula, cholecystectomy, and primary closure of the colon. However, the patient presented a torpid evolution with ascending colon perforation and necrotizing fasciitis in the surgical wound, finally dying of abdominal septic shock.
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References
1. Brandariz Gil L, Fernández de Miguel T, Perea J. Rigler triad in gallstone ileus. Rev Esp Enferm Dig. 2016 Sep;108(9):581-2. PMID: 27615020.
2. Da Cunha T, Sharma B, Goldenberg S. Colonic Gallstone Ileus: Treatment Challenges. Cureus. 2021 Nov 24;13(11):e19869. doi: 10.7759/cureus.19869. PMID: 34963869; PMCID: PMC8709563.
3 .Farkas N, Kaur V, Shanmuganandan A, Black J, Redon C, Frampton AE, West N. A systematic review of gallstone sigmoid ileus management. Ann Med Surg (Lond). 2018 Jan 31;27:32-39. doi: 10.1016/j.amsu.2018.01.004. PMID: 29511540; PMCID: PMC5832643.
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Guerro Moya A, Couto Wörner I, Alonso Aguirre P. Successful gallstone ileus treatment by endoscopy. 8898/2022


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Publication history

Received: 30/04/2022

Accepted: 15/05/2022

Online First: 31/05/2022

Published: 12/12/2022

Article Online First time: 31 days

Article editing time: 226 days


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