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Paper 2
Published in Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw, The Final FRCR, 2020
Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw
A 62 year old woman, with known gallstones, presents to the emergency department with abdominal pain and vomiting. An abdominal radiograph is performed which shows bowel obstruction, pneumobilia and a densely calcified abdominal mass. The doctors suspect the patient has gallstone ileus.
The Gallbladder and Bile Ducts
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
several episodes of this nature over a period of a few weeks and then no more trouble for some months. Jaundice may result if the stone migrates from the gallbladder and obstructs the common bile duct. Rarely, a gallstone can lead to bowel obstruction (gallstone ileus).
Answers
Published in Thomas Hester, Iain MacGarrow, Surgical SBAs for Finals with Explanatory Answers, 2018
Gallstone ileus is when a stone ulcerates through the gall bladder wall into the duodenum and impacts on the narrowest part of the small bowel, i.e. the ileocaecal valve (ileus is actually a misnomer as it is a mechanical obstruction). A key feature is gas in the biliary tree, which can be seen on a plain abdominal film.
Developments in the Diagnosis and Management of Cholecystoenteric Fistula
Published in Journal of Investigative Surgery, 2022
Ying-Yu Liu, Shi-Yuan Bi, Quan-Run He, Ying Fan, Shuo-Dong Wu
Gallstone ileus is a rare complication of CEF, most often seen in elderly women. The age of onset is 70 − 80 years, and the male to female ratio is 1:3.5–4.5 [6, 7]. Gallstone ileus refers to gallstones passing through the fistula between the gallbladder and the digestive tract or through the Oddi sphincter into the duodenum. The latter possibly occurs after endoscopic retrograde cholangiopancreatography (ERCP) and sphincterotomy (EST) [8]. Gallstone ileus is most commonly the result of a gallstone causing small bowel obstruction. Gallstones was trapped in the distal ileum and ileocecal valve, which is associated with narrowed ileocecal lumen and ileocecal valve. Sigmoid obstruction can also occur when stones enter the colon through the CCF or the ileocecal valve [9, 10]. When CEF exists, the gallstones may migrate to the stomach and form a gastrolith [11]. The impacted gallstones are approximately 4 cm in size, which is within the ≥ 2.5 cm range considered impaction prone [12, 13]. Obstruction of the gastric outlet and proximal duodenal is rare and is called Bouveret syndrome, first reported by Leon Bouveret in 1896 [14].
Rare cause of gastric outlet obstruction
Published in Journal of Community Hospital Internal Medicine Perspectives, 2018
Bouveret’s syndrome is a rare cause of gastric outlet obstruction. Gallstone ileus is seen in 1%–4% of small bowel obtruction, and involves duodenum in only 1%–3% of cases [1]. It is a variant of gallstone ileus resulting in gastroduodenal obstruction secondary to gallstone impaction in the duodenum. The stones enter the small bowel via cholecysto-enteric fistula which is created by chronic inflammation of the adherent biliary system and bowel walls causing necrosis [2]. Bouveret’s syndrome is usually caused by stones that are larger than stones that cause gallstone ileus. The average size is 4.6 cm compared to 2.5 cm [2]. It complicates 0.3%–5% of cholelithiasis [2,3].
Clinical outcome of gallstone ileus; a single-centre experience of case series and review of the literature
Published in Acta Chirurgica Belgica, 2022
Feyyaz Gungor, Yigit Atalay, Nihan Acar, Emine Ozlem Gur, Ibrahim Kokulu, Turan Acar, Sebnem Karasu, Osman Nuri Dilek
Gallstone ileus (GI) is a rare complication of cholelithiasis, occurring in 0.5% of its patients [1,2]. GI accounts for 1–4% of the mechanical bowel obstructions, and 25% of all types of bowel obstructions in individuals aged 65 years and above [3]. The average age of diagnosis is 74 years [4], and patients are usually elderly, obese and suffer from severe comorbidities. It has been reported to be more common among in women than in men (ratio of 3–7:1) [2,3]. The pathophysiology of GI is unclear, but most patients have bilioenteric fistula. Gall bladder usually fistulises to the duodenum, less frequently to the colon and rarely to the stomach [2].