Kolak Juraj, Romic Ivan, Silovski Hrvoje, Krzelj Kristina
Department of Hepatobiliary Surgery and Organ Transplantation, University Hospital Center Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia.
Department of Cardiac Surgery, University Hospital Center Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia.
J Surg Case Rep. 2025 Aug 21;2025(8):rjaf544. doi: 10.1093/jscr/rjaf544. eCollection 2025 Aug.
Typical gallstone ileus includes small intestine obstruction caused by the gallstone passing from the gallbladder through the common bile duct (CBD). The case of gallstone ileus with simultaneous obstructive jaundice and intestinal ischemia is an extremely rare scenario. Computed tomography of the abdomen and pelvis is the method of choice for the diagnosis. While some cases may be treated conservatively, surgery is often required, with the approach tailored to the patient's general condition and medical history. Hereby, we present a case of an 88-year-old lady with gallstone ileus, obstructive jaundice, and radiologic signs of intestinal ischemia. Urgent surgery revealed a 3 cm gallstone in the ischemic distal jejunum and another in the CBD. Cholecystectomy, duodenal wall repair, choledochotomy with stone extraction, and T-drainage were performed. The patient was discharged from the hospital on the 25th postoperative day, and 1 year after the surgery, is in good general condition.
典型的胆石性肠梗阻包括胆结石从胆囊经胆总管(CBD)进入小肠导致的小肠梗阻。同时伴有梗阻性黄疸和肠缺血的胆石性肠梗阻病例极为罕见。腹部和盆腔计算机断层扫描是诊断的首选方法。虽然有些病例可以保守治疗,但通常需要手术,手术方式需根据患者的一般状况和病史进行调整。在此,我们报告一例88岁女性患者,患有胆石性肠梗阻、梗阻性黄疸以及肠道缺血的影像学表现。急诊手术发现缺血的空肠远端有一枚3厘米的胆结石,胆总管内还有一枚。进行了胆囊切除术、十二指肠壁修补术、胆总管切开取石术和T管引流术。患者术后第25天出院,术后1年,一般状况良好。