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胆石性肠梗阻:机械性小肠梗阻的罕见病因

Gallstone Ileus: An Improbable Cause of Mechanical Small Bowel Obstruction.

作者信息

Lourenço Sara, Pereira Ana Marta, Reis Jose, Guimarães Marta, Nora Mário

机构信息

General Surgery, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, PRT.

出版信息

Cureus. 2020 Nov 12;12(11):e11460. doi: 10.7759/cureus.11460.

Abstract

Gallstone ileus (GI) is a rare complication of cholelithiasis and a rare cause of small bowel obstruction. It usually affects elderly women and the symptoms are nonspecific, both contributing to a delay in diagnosis and a high mortality rate. It is necessary to have a high suspicion index for diagnosis and abdominal CT is the gold standard imaging for the diagnosis. We present a case report of an 87-year-old man who presented to the ED with abdominal pain and vomiting for the last 20 days. A GI was diagnosed and he underwent enterolithotomy to remove the stone. Unfortunately, the patient died on the 13th postoperative day with multiorgan failure. The treatment and the time at which it is performed must be adapted to each patient.

摘要

胆石性肠梗阻(GI)是胆石症的一种罕见并发症,也是小肠梗阻的罕见原因。它通常影响老年女性,且症状不具特异性,这两者都导致诊断延迟和高死亡率。诊断时必须有较高的怀疑指数,腹部CT是诊断的金标准影像学检查。我们报告一例87岁男性病例,该患者因腹痛和呕吐在急诊科就诊20天。诊断为胆石性肠梗阻,他接受了肠石切除术以取出结石。不幸的是,患者在术后第13天死于多器官功能衰竭。治疗方法及其实施时间必须根据每个患者的情况进行调整。

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本文引用的文献

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Gallstone ileus: a review.胆石性肠梗阻:综述
BMJ Open Gastroenterol. 2019 Nov 24;6(1):e000344. doi: 10.1136/bmjgast-2019-000344. eCollection 2019.
2
Gallstone ileus managed with enterolithotomy.采用肠石切除术治疗胆石性肠梗阻。
BMJ Case Rep. 2019 Oct 13;12(10):e231581. doi: 10.1136/bcr-2019-231581.
3
Gallstone Ileus: An Unlikely Cause of Mechanical Small Bowel Obstruction.胆结石性肠梗阻:机械性小肠梗阻的罕见病因
Case Rep Gastroenterol. 2017 Jun 15;11(2):389-395. doi: 10.1159/000475749. eCollection 2017 May-Aug.
5
Gallstone ileus: An overview of the literature.胆结石性肠梗阻:文献综述
Rev Gastroenterol Mex. 2017 Jul-Sep;82(3):248-254. doi: 10.1016/j.rgmx.2016.07.006. Epub 2017 Apr 19.
9
Acute intestinal obstruction due to gallstone ileus.胆结石性肠梗阻所致的急性肠梗阻
Rev Col Bras Cir. 2013 Jul-Aug;40(4):275-80. doi: 10.1590/s0100-69912013000400004.

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