Ayeni Itunuayo V, Williams Nicholas J
Department of General Surgery, William Harvey Hospital, Ashford, Kent, UK.
BMJ Case Rep. 2012 Jul 20;2012:bcr0320126008. doi: 10.1136/bcr-03-2012-6008.
Gallstone ileus is a rare but significant cause of intestinal obstruction particularly among the elderly population. Symptoms are often vague and therefore a high suspicious index is required for successful diagnosis. In this report, we present the case of an 87-year-old gentleman with a background history of cholelithiasis and ileostomy for ulcerative colitis who was admitted with a 24-h history of his stoma not functioning. He had an abdominal x-ray and CT which were consistent with small bowel obstruction with no identifiable cause. He underwent an examination of his stoma under general anaesthesia which revealed a 2.5 cm gallstone wedged several centimetres near the entry point of the stoma. The purpose of this report is to highlight the importance of considering gallstones as a potential cause of a non-functioning stoma in any patient with a significant history of cholelithiasis.
胆结石性肠梗阻是肠梗阻的一种罕见但重要的病因，尤其在老年人群中。症状通常不明确，因此成功诊断需要较高的怀疑指数。在本报告中，我们介绍了一名87岁男性患者的病例，他有胆石症病史，因溃疡性结肠炎接受了回肠造口术，此次因造口24小时未正常工作入院。他进行了腹部X光和CT检查，结果符合小肠梗阻，但未发现明确病因。他在全身麻醉下接受了造口检查，发现一枚2.5厘米的胆结石嵌顿在造口入口点附近几厘米处。本报告的目的是强调，对于任何有明显胆石症病史的患者，都要考虑胆结石是造口功能障碍的潜在原因。
