García-Marín A, Pérez-López M, Pérez-Bru S, Compañ-Rosique A
Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario San Juan de Alicante, Alicante, España; Departamento de Patología y Cirugía, Universidad Miguel Hernández, Elche, España.
Enfermería, Hospital Universitario San Juan de Alicante, Alicante, España.
Rev Gastroenterol Mex. 2014 Jul-Sep;79(3):211-3. doi: 10.1016/j.rgmx.2014.05.008. Epub 2014 Sep 8.
Gallstone ileus is a rare complication of cholelithiasis. It is characterized by bowel obstruction secondary to gallstone impaction at some point of the gastrointestinal tract due to the existence of a bilioenteric fistula. The aim of this analysis was to evaluate our experience through a retrospective study, covering a 12-year period. It included 14 cases (10 women and 4 men) with a median age of 81 years; 11 of the patients had comorbidities. The main analytic alteration was an increase in urea (median 79mg/dl). Diagnosis was confirmed through abdominal computed tomography in 10 cases and plain abdominal x-ray in 4. The stone was located in the jejunum in 6 cases, the ileum in 6, and the sigmoid colon in one; the mean stone size was 3cm. There were 11 cases of cholecystoduodenal fistula, one case of cholecystocolonic fistula, and one idiopathic fistula. Two patients died, including the patient that did not undergo surgery.
胆石性肠梗阻是胆石症的一种罕见并发症。其特征是由于存在胆肠瘘,胆结石在胃肠道某一部位嵌顿继发肠梗阻。本分析的目的是通过一项为期12年的回顾性研究评估我们的经验。该研究纳入了14例患者(10名女性和4名男性),中位年龄为81岁;其中11例患者有合并症。主要分析指标变化是尿素升高(中位值79mg/dl)。10例通过腹部计算机断层扫描确诊,4例通过腹部平片确诊。结石位于空肠6例,回肠6例,乙状结肠1例;结石平均大小为3cm。有11例胆囊十二指肠瘘,1例胆囊结肠瘘,1例特发性瘘。2例患者死亡,包括未接受手术的患者。