Volume 7, Issue 1, March 2019, Page: 25-28
Gallstone Ileus: An Uncommon Cause of Acute Abdomen
Rachida Saouab, Department of Radiology, Military Hospital, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech, Morocco
Fatima Zahra Rhouni, Department of Radiology, Military Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
Mohammed Mahi, Department of Radiology, Military Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
Hassan Boumdien, Department of Radiology, Military Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
Touriya Amil, Department of Radiology, Military Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
Jamal El Fenni, Department of Radiology, Military Hospital, Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, Morocco
Received: Mar. 5, 2019;       Accepted: Apr. 26, 2019;       Published: May 17, 2019
DOI: 10.11648/j.ijmi.20190701.14      View  121      Downloads  20
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.
Keywords
Gallstone, Ileus, Bowel Obstruction, Pneumobilia, Acute Abdomen, CT Scan
To cite this article
Rachida Saouab, Fatima Zahra Rhouni, Mohammed Mahi, Hassan Boumdien, Touriya Amil, Jamal El Fenni, Gallstone Ileus: An Uncommon Cause of Acute Abdomen, International Journal of Medical Imaging. Vol. 7, No. 1, 2019, pp. 25-28. doi: 10.11648/j.ijmi.20190701.14
Copyright
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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