Eiref Andrew D, Hester Karri, Glaspy Tyler, Sarkisova Anna, Anand Sohini, Zimmerman Patrick W, Nicoara Michael, Patel Krishan, Walden Heath, Eiref Simon D
Department of Surgery, Department of Pathology, Danbury Hospital, 24 Hospital Ave, Danbury, CT 06810, United States.
J Surg Case Rep. 2024 Oct 19;2024(10):rjae647. doi: 10.1093/jscr/rjae647. eCollection 2024 Oct.
Gallstone ileus results in a mechanical small bowel obstruction when an itinerant gallstone tumbles downstream and obstructs the bowel lumen. Associated proximal intestinal injury with perforation is rare, and concomitant perforation of multiple segments of bowel in the setting of gallstone ileus has never been reported in the literature. We are reporting the case of a 67-year-old female patient who had gallstone ileus causing perforation of multiple segments of small bowel. At operation, she was found to have a 3.2-cm gallstone lodged at the terminal ileum, perforation of both the mid ileum and mid jejunum, and gross enteric spillage. She underwent removal of the gallstone and small bowel resection × 2. She was initially left in discontinuity with an open abdomen. She returned to the operating room 2 days later for bowel anastomosis and abdominal closure. She recovered well after surgery and was discharged home.
胆结石性肠梗阻是指游走性胆结石向下移动并阻塞肠腔，导致机械性小肠梗阻。伴有近端肠损伤穿孔的情况较为罕见，且在胆结石性肠梗阻背景下多节段肠管同时穿孔的情况在文献中尚无报道。我们报告一例67岁女性患者，其胆结石性肠梗阻导致多节段小肠穿孔。手术中发现一枚3.2厘米的胆结石嵌顿于回肠末端，回肠中段和空肠中段均有穿孔，且有大量肠内容物外溢。她接受了胆结石取出术及两次小肠切除术。起初她的肠管处于离断状态，腹部开放。两天后她返回手术室进行肠吻合和腹壁关闭。术后她恢复良好，出院回家。
