Sipos Péter, Szabó Szilárd, Ondrejka Pál, Hermann Csaba, Elek Gábor, Sugár István
Semmelweis Egyetem AOK II. sz. Sebészeti Klinikam, Budapest.
Magy Seb. 2004 Oct;57(5):293-6.
A big gallstone penetrating through a bilio-digestive fistula into the bowel can make a complete obstruction of it in the majority of the cases requiring an urgent operation. It is a rare situation that a fistula like this leads into the colon and the stone makes a large bowel obstruction. A 72-year-old male patient was admitted to our department with the symptoms of colon obstruction. After the examinations he underwent an explorative laparotomy. During the course of the operation an obstruction was found in the proximal third of the descending colon. A subtotal colectomy was carried out. At the opening of the resected colon a big gallstone was found as the cause of the obstruction, which simulated a tumorous obstruction. We present through this case the possibilities and results of the diagnosis and treatment of gallstone ileus. We conclude that in the prevention of gallstone ileus, the early operative treatment of detected gallstone is essential.
一枚大的胆结石通过胆肠瘘穿入肠道，在大多数情况下会导致肠道完全梗阻，需要紧急手术。像这样的瘘通向结肠且结石导致大肠梗阻的情况较为罕见。一名72岁男性患者因结肠梗阻症状入院。检查后他接受了剖腹探查术。手术过程中，在降结肠近端三分之一处发现梗阻。进行了次全结肠切除术。在切除的结肠开口处发现一枚大的胆结石是梗阻原因，其形似肿瘤性梗阻。我们通过该病例展示了胆石性肠梗阻的诊断和治疗的可能性及结果。我们得出结论，在预防胆石性肠梗阻方面，对检测到的胆结石进行早期手术治疗至关重要。
