Noda Kisho, Ohno Hirofumi, Naito Keiko, Shirakabe Katsudai, Muramatsu Hirotada, Funakoshi Hiraku
Department of Emergency and Critical Care Medicine, Tokyobay Urayasu Ichikawa Medical Center, Urayasu, Japan.
Department of General Surgery, Tokyobay Urayasu Ichikawa Medical Center, Urayasu, Japan.
Case Rep Gastroenterol. 2025 Jun 5;19(1):397-402. doi: 10.1159/000545980. eCollection 2025 Jan-Dec.
Gallstone ileus is rare but with high mortality. Although gallstone ileus usually requires urgent enterolithotomy, cholecystectomy, and fistula closure, we present a case of recurrent gallstone ileus treated with enterolithotomy alone.
A 69-year-old female presented to the emergency department with nausea, emesis, and abdominal pain. After computed tomography revealed the diagnosis of gallstone ileus, enterolithotomy was performed without postoperative complications. Cholecystectomy and fistula closure were not performed due to inaccessibility to the gallbladder and the high surgical invasion required. Four months later, the patient developed gallstone ileus again. A second enterolithotomy was performed immediately, resulting in a favorable outcome without complications.
In managing gallstone ileus, particularly in cases with surgical limitations, a less invasive strategy could be a reasonable option.
胆结石性肠梗阻虽罕见但死亡率高。尽管胆结石性肠梗阻通常需要紧急行肠石切除术、胆囊切除术和瘘管闭合术，但我们报告一例仅通过肠石切除术治疗的复发性胆结石性肠梗阻病例。
一名69岁女性因恶心、呕吐和腹痛就诊于急诊科。计算机断层扫描显示诊断为胆结石性肠梗阻后，进行了肠石切除术，术后无并发症。由于无法触及胆囊且手术侵袭性高，未进行胆囊切除术和瘘管闭合术。四个月后，患者再次发生胆结石性肠梗阻。立即进行了第二次肠石切除术，结果良好，无并发症。
在处理胆结石性肠梗阻时，特别是在存在手术限制的情况下，侵入性较小的策略可能是一个合理的选择。
