Hildebrandt J, Herrmann U, Diettrich H
Klinik für Chirurgie, Medizinischen Akademie Carl Gustav Carus, Dresden.
Chirurg. 1990 May;61(5):392-5.
An analysis of 104 cases of gallstone ileus in 102 patients is presented. Biliary stones reach the intestinal tract through a biliodigestive fistula in 80-85% and on natural way in 15-20%. Clinical symptoms depend on mechanism of obstruction. It shows 3 forms of course: peritonitical form (20%), remittent form (30%) and typical intestinal obturation (50%). Roentgenological findings show aerobilia in 36%, dystope radiopaque stones in 8% and signs of obstruction in 97% of investigations. The main concern in gallstone ileus should be to relieve the intestinal obstruction and not cholelithiasis. The mortality rate declined during reported time from 40-50% to 25%.
本文对102例患者的104例胆石性肠梗阻病例进行了分析。80 - 85%的胆石通过胆肠瘘进入肠道,15 - 20%通过自然途径进入。临床症状取决于梗阻机制。病程表现为3种形式:腹膜炎型(20%)、弛张型(30%)和典型肠梗阻型(50%)。X线检查结果显示,36%有气胆,8%有异位不透X线结石,97%有梗阻征象。胆石性肠梗阻的主要关注点应是解除肠梗阻,而非胆结石。在报告期内,死亡率从40 - 50%降至25%。