Kirac Iva, Nikolić Marko, Kulis Tomislav, Kovacević Dujo, Lovrencić-Prpić Gordana, Kirac Petar
University Department of Surgery, Sestre milosrdnice University Hospital, Zagreb, Croatia.
Acta Clin Croat. 2010 Sep;49(3):305-8.
Gallstone ileus with impaction of gallstone in distal duodenum is an extremely rare complication of cholecystolithiasis. Gallstone ileus in itself accounts for less than 1% of these complications with 800 cases described so far. However, there are less than 15 cases described with the impaction of gallstone in distal duodenum. We report a case of an 84-year-old male patient in whom gallstone impacted in distal duodenum was found by ultrasonography and confirmed by computed tomography. Cholecystitis and a remaining large gallstone in the gallbladder were found intraoperatively, which made us opt for one-step procedure, i.e. lithotomy and fistula repair with cholecystectomy. Due to the rare position of impacted gallstone, we believe that cases like this should be reported in detail in order to generate enough data for establishing optimal treatment options.
胆囊结石嵌顿于十二指肠远端导致的胆石性肠梗阻是胆囊炎极其罕见的并发症。胆石性肠梗阻本身在这些并发症中所占比例不到1%，迄今为止报道的病例有800例。然而，胆囊结石嵌顿于十二指肠远端的病例报道不足15例。我们报告一例84岁男性患者，超声检查发现胆囊结石嵌顿于十二指肠远端，计算机断层扫描予以证实。术中发现胆囊炎及胆囊内残留大的结石，这使我们选择一步手术，即取石术及胆瘘修补术加胆囊切除术。由于嵌顿结石位置罕见，我们认为此类病例应详细报道，以便积累足够数据以确定最佳治疗方案。
