Koenig Zachary A, Turner Jason
School of Medicine, West Virginia University, Morgantown, USA.
Department of Surgery, West Virginia University, Martinsburg, USA.
Cureus. 2021 Mar 24;13(3):e14078. doi: 10.7759/cureus.14078.
Gallstone ileus is an uncommon cause of intestinal obstruction in the elderly. It is typically recognized on computed tomography by the presence of pneumobilia and a gallstone in the right iliac fossa. Nonetheless, it is important to consider that gallstone ileus may represent the presentation of another pathology rather than an entity on its own. Here, we report successful retrieval of a gallstone that was causing ileus. Intraoperatively, the gallstone was noted lodged in the terminal ileum distal to an incidentally noted Meckel's diverticulum. The gallstone was milked proximally into the Meckel's diverticulum and the base was transected. This case illustrates a rare, but unique, surgical technique utilizing a small bowel diverticulum as a vector for stone removal.
胆结石性肠梗阻是老年人肠梗阻的一种罕见病因。在计算机断层扫描中,通常可通过右髂窝内存在气腹和胆结石来识别。尽管如此,重要的是要考虑到胆结石性肠梗阻可能代表的是另一种病理表现,而非独立的疾病实体。在此,我们报告成功取出导致肠梗阻的胆结石。术中发现胆结石嵌顿于回肠末端,其远端有一个偶然发现的梅克尔憩室。将胆结石向近端挤入梅克尔憩室并切断其底部。本病例说明了一种罕见但独特的手术技术,即利用小肠憩室作为取出结石的载体。