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发热性梗阻提示胆石性肠梗阻。

A febrile occlusion revealing a biliary ileus.

作者信息

Boudou Mohamed, Jabi Rachid, Maamar Khalil, Soussan Haitam, Taibi Soufiane, Bouziane Mohammed

机构信息

Department of General Surgery, Mohamed VI University Hospital, Faculty of Medicine and Pharmacy, Laboratory of Anatomy, Microsurgery and Surgery Experimental and Medical Simulation, Oujda, Morocco.

Department of General Surgery, Mohamed VI University Hospital, Faculty of Medicine and Pharmacy, Laboratory of Anatomy, Microsurgery and Surgery Experimental and Medical Simulation, Oujda, Morocco.

出版信息

Int J Surg Case Rep. 2022 May;94:107113. doi: 10.1016/j.ijscr.2022.107113. Epub 2022 Apr 22.

Abstract

Biliary ileus is a consequence of the migration of a gallstone from the gallbladder to the digestive tract, most often via a biliodigestive fistula that causes a bowel obstruction. The clinic is atypical and capricious, including bowel obstruction and signs of cholecystitis, causing a delay in diagnosis. The therapeutic objective is to remove the intestinal obstacle by an enterotomy with stone extraction, with or without treatment of the biliary pathology (cholecystectomy and biliary fistula cure). The surgery remains the treatment of choice; laparoscopy and endoscopy present a less invasive alternative and are beginning to prove their effectiveness. The morbi-mortality remains high for biliary ileus, this is principally caused by the delay in diagnosis.

摘要

胆石性肠梗阻是胆结石从胆囊移行至消化道的结果,通常是通过导致肠梗阻的胆肠瘘所致。其临床表现不典型且多变,包括肠梗阻和胆囊炎体征,这导致诊断延迟。治疗目标是通过肠切开取石术清除肠道梗阻,无论是否同时治疗胆道病变(胆囊切除术和治愈胆瘘)。手术仍然是首选治疗方法;腹腔镜检查和内镜检查提供了侵入性较小的替代方案,并且已开始证明其有效性。胆石性肠梗阻的病死率仍然很高,这主要是由诊断延迟所致。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e50e/9171529/d7fe8c0228e7/gr1.jpg

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