Mishan Mohammad, Mehdikhani Bahareh
General Surgery, Abadan University of Medical Sciences, Abadan, IRN.
Radiology, School of Medicine, Iran University of Medical Sciences, Tehran, IRN.
Cureus. 2022 Aug 13;14(8):e27978. doi: 10.7759/cureus.27978. eCollection 2022 Aug.
Gallstone ileus is one of the rare and insidious causes of small bowel obstruction, which should always be kept in mind by clinicians, especially when encountering older people with a history of gallstones disease. The high mortality and morbidity rate associated with the condition can be mostly attributed to delayed or misdiagnosis. Imaging modalities, particularly CT scans, play an important role in correct and timely diagnosis. We present the case of a 65-year-old man with a two-year history of colicky biliary pain, who had severe abdominal pain with obstructive symptoms for five days before admission. The diagnosis of gallstone ileus is made using CT scan findings. Enterolithotomy alone was performed three days later. A second, smaller migrated gallstone was also found, which excreted spontaneously. After 20 days, the patient achieved full recovery and was discharged.
胆石性肠梗阻是小肠梗阻的罕见且隐匿病因之一,临床医生应始终牢记,尤其是在遇到有胆石病史的老年人时。与该病症相关的高死亡率和发病率主要可归因于诊断延迟或误诊。影像学检查方法,尤其是CT扫描,在正确及时的诊断中起着重要作用。我们报告一例65岁男性病例,该患者有两年胆绞痛病史,入院前五天出现严重腹痛并伴有梗阻症状。根据CT扫描结果诊断为胆石性肠梗阻。三天后仅进行了肠石切除术。还发现了另一颗较小的迁移性胆石,其自行排出。20天后,患者完全康复并出院。