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乙状结肠胆结石性肠梗阻:日本的一例病例报告及文献综述

Sigmoid gallstone ileus: A case report and literature review in Japan.

作者信息

Inukai Koichi, Uehara Shuhei, Miyai Hirotaka, Takashima Nobuhiro, Yamamoto Minoru, Kobayashi Kenji, Tanaka Moritsugu, Hayakawa Tetsushi

机构信息

Department of Surgery, Kariya Toyota General Hospital, 5-15 Sumiyoshi-cho, Kariya, Aichi, 448-8505, Japan.

Department of Surgery, Kariya Toyota General Hospital, 5-15 Sumiyoshi-cho, Kariya, Aichi, 448-8505, Japan.

出版信息

Int J Surg Case Rep. 2018;49:51-54. doi: 10.1016/j.ijscr.2018.06.015. Epub 2018 Jun 23.

Abstract

INTRODUCTION

Gallstone as a cause of bowel obstruction is rare, and its occurrence in the colon is very infrequent. Here, we report the case of sigmoid gallstone ileus treated with one-stage operation.

CASE PRESENTATION

A 65-year-old man visited our hospital because of abdominal pain and nausea. On the basis of the results of computed tomography, the patient was diagnosed with sigmoid gallstone ileus through cholecystocolonic fistula, and an emergency laparotomy was performed. Enterolithotomy, cholecystectomy, and fistula closure were performed in one-stage operation. Postoperatively, the patient developed biliary leakage, which rapidly recovered with conservative therapy.

DISCUSSION AND CONCLUSION

The surgical treatment of gallstone ileus remains controversial. For postoperative infection control, one-stage operation can be considered for patients with gallstone ileus associated with cholecystocolonic fistula.

摘要

引言

胆结石作为肠梗阻的病因较为罕见,其在结肠中的发生更是极为少见。在此,我们报告一例经一期手术治疗的乙状结肠胆结石性肠梗阻病例。

病例介绍

一名65岁男性因腹痛和恶心前来我院就诊。根据计算机断层扫描结果,该患者通过胆囊结肠瘘被诊断为乙状结肠胆结石性肠梗阻,并接受了急诊剖腹手术。一期手术进行了肠切开取石术、胆囊切除术和瘘管闭合术。术后,患者出现胆漏,经保守治疗后迅速康复。

讨论与结论

胆结石性肠梗阻的外科治疗仍存在争议。为控制术后感染,对于合并胆囊结肠瘘的胆结石性肠梗阻患者可考虑一期手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3138/6039887/614ea01305f2/gr1.jpg

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