Mouni Omar, Bouziane Mohamed, Gennuso Federico, Ramdani Abdelbassir, Sair Khalid
Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco.
Compiegne-Noyon Hospital, Compiegne, France.
Ann Med Surg (Lond). 2023 Feb 7;85(2):172-174. doi: 10.1097/MS9.0000000000000057. eCollection 2023 Feb.
Gallstone ileus is an uncommon cause of intestinal obstruction. It is caused when a gallstone migrates through an enterobiliary fistula (most often between the duodenum and the gallbladder) and is impacted in the digestive system, most often in the terminal ileum toward the ileocaecal valve.
Here the authors report the case of a 74-year-old woman who was admitted to Compiegne Hospital in France for a gallstone ileus with the sigmoid colon as the impaction site, which is an even more rare cause of intestinal obstruction. The enterobiliary fistula was between the colon and the gallbladder.The gallstone was removed surgically with a colotomy, without treating the fistula, and after a failed endoscopic attempt to extract the stone. The follow-up was without complications, and a colposcopy showed spontaneous closure of the fistula after 6 weeks.
The surgical closure of an enterobiliary fistula is an option that should be considered, but it can lead to higher morbidity. That is why the authors opted out of it, especially considering that spontaneous closure of the fistulae can happen, as it did in our case.
胆石性肠梗阻是肠梗阻的一种罕见病因。它是由于胆结石通过肠胆瘘（最常见于十二指肠和胆囊之间）迁移并嵌顿于消化系统，最常见于回肠末端靠近回盲瓣处而引起的。
本文作者报告了一例74岁女性患者的病例，该患者因胆石性肠梗阻入住法国贡比涅医院，结石嵌顿部位为乙状结肠，这是一种更为罕见的肠梗阻病因。肠胆瘘位于结肠和胆囊之间。结石通过结肠切开术手术取出，未处理瘘管，此前内镜取石尝试失败。随访无并发症，结肠镜检查显示瘘管在6周后自行闭合。
肠胆瘘的手术闭合是一种应考虑的选择，但可能导致更高的发病率。这就是作者未选择此方法的原因，特别是考虑到瘘管可能会自行闭合，就像我们这个病例一样。
