Spaziani Erasmo, Picchio Marcello, Di Filippo Annalisa, De Angelis Francesco, Marino Giuseppe, Stagnitti Franco
Department of Surgery, University of Rome "Sapienza", Polo Pontino, Terracina, Latina, Italy.
Ann Ital Chir. 2010 Jan-Feb;81(1):53-5.
Gallstone ileus is uncommon. Gallstone impaction in the jejunum was rarely reported. We report two cases of gallstone impaction in the proximal jejunum and in the distal ileum. One patient was treated with enterolithotomy alone and in the other one enterolithotomy was combined to cholecystectomy and repair of a cholecystoduodenal fistula. Contrast-enhanced computed tomography of the abdomen is the mainstay of diagnosis. One-stage procedure including both enterolithotomy and cholecystectomy with bilioenteric fistula repair should be reserved to low-risk patients.
胆结石性肠梗阻并不常见。空肠内胆结石嵌顿的报道很少。我们报告了两例分别发生在空肠近端和回肠远端的胆结石嵌顿病例。其中一名患者仅接受了肠石切除术,另一名患者则接受了肠石切除术,并联合胆囊切除术和胆囊十二指肠瘘修补术。腹部增强计算机断层扫描是诊断的主要手段。包括肠石切除术、胆囊切除术和胆肠瘘修补术的一期手术应仅适用于低风险患者。