Aslam Jamil, Patel Prashant, Odogwu Steve
Department of Surgery, Walsall Manor Hospital, Walsall, UK.
BMJ Case Rep. 2014 Apr 19;2014:bcr2013203345. doi: 10.1136/bcr-2013-203345.
Gallstone ileus is a serious complication of cholelithiasis where mechanical small bowel obstruction occurs. The recurrence of gallstone ileus is rare. The 67-year-old woman in this case report had three known gallstones transit her small bowel with two causing obstruction and the third causing a 'tumbling phenomenon'. As we have an ageing population, and gallstone ileus has a higher incidence in the over 65 age group, associated with increased comorbidities and hence greater mortality rates, it is imperative to establish the best surgical intervention for it. This case report highlights the difference CT of the abdomen has made to the diagnosis of gallstone ileus and the pros and cons of the surgical management options.
胆结石性肠梗阻是胆石症的一种严重并发症,会导致机械性小肠梗阻。胆结石性肠梗阻的复发很罕见。本病例报告中的67岁女性有三颗已知的胆结石通过她的小肠,其中两颗造成梗阻,第三颗引起“翻滚现象”。由于我们的人口老龄化,且胆结石性肠梗阻在65岁以上年龄组中的发病率较高,同时合并症增加,因此死亡率更高,所以必须确定针对它的最佳手术干预措施。本病例报告强调了腹部CT对胆结石性肠梗阻诊断的作用以及手术管理方案的利弊。