Crosen Matelin, Ghattas Paul, Sandhu Rovinder
Department of Surgery, Lehigh Valley Health Network, Allentown, PA, USA.
J Surg Case Rep. 2021 May 18;2021(5):rjab137. doi: 10.1093/jscr/rjab137. eCollection 2021 May.
Gallstone ileus is a rare complication of cholelithiasis, representing 1% of bowel obstructions. The usual site of obstruction is the ileocecal valve, though other sites have been reported. Here, we present two cases of gallstone ileus within the distal colon requiring surgical intervention. Two elderly females presented with vague abdominal symptoms secondary to large bowel obstruction from gallstone impaction. Both underwent attempted endoscopic retrieval without success. Patient 1 required laparoscopy converted to exploratory laparotomy with colotomy and removal of the stone. Patient 2 required partial colectomy and end colostomy formation due to acute sigmoid inflammation. Gallstone ileus is a rare cause of intestinal obstruction, though incidence increases with age. Cholecystocolonic fistulas allow stones to bypass the ileocecal valve, with the potential for impaction in the colon at the site of a stricture or tortuosity. Surgical intervention may be required in cases not amenable to successful endoscopic retrieval.
胆石性肠梗阻是胆石症的一种罕见并发症，占肠梗阻的1%。梗阻的常见部位是回盲瓣，不过也有其他部位的报道。在此，我们呈现两例发生在结肠远端的胆石性肠梗阻病例，均需手术干预。两名老年女性因胆石嵌顿导致大肠梗阻而出现腹部隐痛症状。两人均尝试内镜取石但未成功。患者1需要先进行腹腔镜检查，后转为剖腹探查术，行结肠切开并取出结石。患者2因急性乙状结肠炎症需要行部分结肠切除术并进行结肠造口术。胆石性肠梗阻是肠梗阻的罕见病因，但其发病率随年龄增长而增加。胆囊结肠瘘可使结石绕过回盲瓣，有可能在结肠的狭窄或迂曲部位发生嵌顿。对于无法通过内镜成功取石的病例，可能需要进行手术干预。
