Year 2022 / Volume 114 / Number 12
Letter
Endoscopic resolution of intestinal obstruction secondary to colonic gallstone ileus and radicular stenosis of the sigma

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DOI: 10.17235/reed.2022.8905/2022

Francisco López Romero-Salazar, Elena Gómez Domínguez, Mónica Barreales Valbuena, Pablo Hernán Ocaña,

Abstract
A 93-year-old woman with a history of endometrial adenocarcinoma treated with surgery and pelvic radiotherapy that led to radicular stenosis in the sigma and acute biliary pancreatitis, without subsequent cholecystectomy. She attended the emergency department for abdominal pain, vomiting and abdominal distension, with metallic noises. An abdominal CT scan showed a gallbladder with cholelithiasis, in wide contact with the colonic framework and dilation of the colonic loops with hydro-aerial levels with a partially calcified image embedded in the known sigmoid stenosis, compatible with intestinal obstruction. Given the high surgical risk, colonoscopy was performed, which identified an impassable punctate stricture with a fibrous appearance. Pneumatic dilatation and subsequent removal of gallstones with biopsy forceps was performed, with an adequate evolution. While gallstone ileus is a rare condition that accounts for 5% of episodes of intestinal obstruction, its location in the colon is even rarer. It is usually managed surgically, with a significant impact on morbidity. This case is of interest because of the infrequent occurrence of obstruction secondary to these two concomitant causes and the possible usefulness of endoscopic treatment in patients at high surgical risk.
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References
1. Inukai K. Gallstone ileus: a review. BMJ Open Gastroenterology. 2019;6(1):e000344. doi: 10.1136/bmjgast-2019-000344.
2. Da Cunha T, Sharma B, Goldenberg S. Colonic Gallstone Ileus: Treatment Challenges. Cureus. 2021. doi: 10.7759/cureus.19869
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Citation tools
López Romero-Salazar F, Gómez Domínguez E, Barreales Valbuena M, Hernán Ocaña P. Endoscopic resolution of intestinal obstruction secondary to colonic gallstone ileus and radicular stenosis of the sigma . 8905/2022


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Publication history

Received: 04/05/2022

Accepted: 06/05/2022

Online First: 24/05/2022

Published: 12/12/2022

Article Online First time: 20 days

Article editing time: 222 days


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