Ivanov I, Beuran M, Venter M D, Iftimie-Nastase I, Smarandache R, Popescu B, Boştină R
Clinical Emergency Hospital, Bucharest, Romania.
J Med Life. 2012 Sep 15;5(3):335-41. Epub 2012 Sep 25.
Gallstone ileus represents a rare complication (0,3-0,5%) of a serious, but common disease-gallstones, which affect around 10% of the population in the USA and Western Europe. Associated diseases (usually severe), elderly patients, delayed diagnosis and therapy due to late presentation to the hospital, account for the morbidity and mortality rates described in literature. We present the case of a patient with partial colon obstruction due to a large gallstone that was "lost" during an emergency laparoscopic cholecystectomy. The calculus eroded the intestinal wall, partially occluding the lumen, triggering recurrent Kerwsky-like, subocclusive episodes. The intraperitoneal abscess has spontaneously drained through the subhepatic drain and once the tube has been removed, a persistent intermittent fistula became obvious.
胆结石性肠梗阻是一种严重但常见疾病——胆结石的罕见并发症（0.3%-0.5%），在美国和西欧约10%的人口受胆结石影响。相关疾病（通常较为严重）、老年患者、因就医延迟导致诊断和治疗延误，这些因素导致了文献中所描述的发病率和死亡率。我们报告一例因一枚在急诊腹腔镜胆囊切除术中“丢失”的大结石导致部分结肠梗阻的患者。结石侵蚀肠壁，部分阻塞肠腔，引发类似Kerwsky的反复亚闭塞发作。腹腔脓肿通过肝下引流管自发引流，一旦引流管拔除，一个持续的间歇性瘘管就变得明显。
