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一例胆肠瘘致胆结石性肠梗阻的病例报告:多层螺旋计算机断层扫描特征分析

A case report of gallstone ileus caused by biliary-intestinal fistula: Multidetector computed tomography features analysis.

作者信息

Gao Meimei, Chen Gang, Niu Juanqin, Huang Yonghua, Xue Wei

机构信息

Department of Radiology, The 940th Hospital of Joint Logistic Support Force of Chinese People's Liberation Army, Lanzhou 730000, Gansu Province, China.

Department of Radiology, The 940th Hospital of Joint Logistic Support Force of Chinese People's Liberation Army, Lanzhou 730000, Gansu Province, China.

出版信息

Int J Surg Case Rep. 2025 Feb;127:110993. doi: 10.1016/j.ijscr.2025.110993. Epub 2025 Jan 29.

Abstract

INTRODUCTION AND SIGNIFICANCE

Gallstone ileus is a mechanical intestinal obstruction caused by gallstones or stones from the common bile duct entering the intestinal canal through a biliary-intestinal fistula and becoming impacted. Multidetector computed tomography (MDCT) scanning is the most important auxiliary diagnostic method for this disease.

CASE PRESENTATION

We report a rare case of gallstone ileus involving an elderly female patient and analyze the characteristics of the MDCT images: atrophic cholecystitis, gallstones, the formation of a local duodenal-gallbladder fistula, pneumatosis in the intrahepatic bile ducts of the left lobe of the liver and some extrahepatic bile ducts, intestinal mechanical obstruction, and the presence of an ectopic stone. A partial small bowel resection was performed and the stone was removed.

CLINICAL DISCUSSION

Gallstone ileus is a rare disease that often occurs in elderly women. It has no specific clinical symptoms and is prone to delayed diagnosis and treatment. MDCT scanning is the most sensitive and accurate diagnostic method for gallstone ileus, once the disease is clearly diagnosed, surgical treatment is recommended as soon as possible.

CONCLUSION

The aim of this study is to elevate the understanding and treatment of gallstone ileus.

摘要

引言与意义

胆石性肠梗阻是一种机械性肠梗阻,由胆结石或来自胆总管的结石通过胆肠瘘进入肠道并造成堵塞所致。多层螺旋计算机断层扫描(MDCT)是诊断该病最重要的辅助检查方法。

病例报告

我们报告了一例罕见的老年女性胆石性肠梗阻病例,并分析了MDCT图像特征:萎缩性胆囊炎、胆结石、局部十二指肠-胆囊瘘形成、肝左叶及部分肝外胆管内的肝内胆管积气、肠道机械性梗阻以及存在异位结石。行部分小肠切除术并取出结石。

临床讨论

胆石性肠梗阻是一种罕见疾病,多见于老年女性。它没有特异性临床症状,容易延误诊断和治疗。MDCT扫描是诊断胆石性肠梗阻最敏感、准确的方法,一旦明确诊断,建议尽早进行手术治疗。

结论

本研究旨在提高对胆石性肠梗阻的认识与治疗水平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4b7/11834122/7303252c4c98/gr1.jpg

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