Tonog Paul, Clar Derek T, Ebalo Nicole, Appresai Ovie
Department of Surgery, Cape Fear Valley Medical Center, Fayetteville, NC, USA.
Department of Medicine, Cape Fear Valley Medical Center, Fayetteville, NC, USA.
J Surg Case Rep. 2023 Mar 14;2023(3):rjad135. doi: 10.1093/jscr/rjad135. eCollection 2023 Mar.
Bowel obstruction/ileus is a relatively common occurrence in surgical practice with a predictable clinical presentation and management course. Rarely are these cases found consistent with gallstone etiology. Known as gallstone ileus (GI), this uncommon presentation is found primarily in elderly females (age > 65 years old) with multiple comorbid conditions; usually with coinciding presence of a cholecystoenteric fistula. Surgical management remains controversial due to the rarity of presentation and complexity of related pathological process. We present a case of a 69-year-old female who presented with typical signs/symptoms of bowel obstruction but found to have sigmoid GI on computed tomography imaging evaluation. A single stage exploratory laparotomy with simple enterolithotomy was performed with a positive outcome and uncomplicated postoperative recovery. The primary goal in reporting this case is to continue emphasizing the efficacy of a single stage simple enterolithotomy as the most ideal surgical management of this rare condition.
肠梗阻/肠麻痹在外科实践中较为常见，具有可预测的临床表现和处理过程。这些病例很少与胆结石病因相符。这种不常见的表现被称为胆结石性肠梗阻（GI），主要见于患有多种合并症的老年女性（年龄>65岁）；通常伴有胆囊肠瘘。由于其表现罕见且相关病理过程复杂，手术治疗仍存在争议。我们报告一例69岁女性，她表现出典型的肠梗阻体征/症状，但在计算机断层扫描成像评估中发现为乙状结肠胆结石性肠梗阻。进行了一期探查性剖腹术及简单的肠石切除术，结果良好，术后恢复顺利。报告此病例的主要目的是继续强调一期简单肠石切除术作为这种罕见疾病最理想手术治疗方法的有效性。
