Juárez Ochoa Luis M, Benitez Michael V
General Surgery, Hospital de Especialidades No. 14, Adolfo Ruiz Cortines, Instituto Mexicano del Seguro Social (IMSS), Veracruz, MEX.
General Surgery, Hospital General de Zona 11 (HGZ11) Instituto Mexicano del Seguro Social (IMSS), Xalapa, MEX.
Cureus. 2025 Aug 30;17(8):e91310. doi: 10.7759/cureus.91310. eCollection 2025 Aug.
As an uncommon etiology of bowel obstruction that predominantly affects the elderly, gallstone ileus warrants attention because it frequently arises from cholecystoenteric fistulas and carries disproportionate morbidity when recognition is delayed. This case report details an unusual presentation in an elderly male patient with no history of abdominal surgery who exhibited nonspecific abdominal symptoms. Imaging studies identified Rigler's triad, and computed tomography (CT) confirmed the presence of an ectopic gallstone in the proximal ileum. The patient promptly underwent surgical intervention, including segmental bowel resection due to transmural ischemia, followed by primary anastomosis. His postoperative recovery was uneventful. This case emphasizes the importance of early recognition of gallstone ileus, highlights the diagnostic value of CT, and demonstrates that bowel resection may be necessary when bowel compromise is present. Increased awareness among clinicians can enhance outcomes and reduce complications in similar cases.
作为一种主要影响老年人的罕见肠梗阻病因，胆石性肠梗阻值得关注，因为它常源于胆囊肠瘘，若延误诊断，发病率会过高。本病例报告详细介绍了一名无腹部手术史的老年男性患者的不寻常表现，该患者出现了非特异性腹部症状。影像学检查发现了里格勒三联征，计算机断层扫描（CT）证实近端回肠存在异位胆结石。患者立即接受了手术干预，包括因透壁性缺血进行节段性肠切除，随后进行一期吻合。他术后恢复顺利。本病例强调了早期识别胆石性肠梗阻的重要性，突出了CT的诊断价值，并表明当肠管受损时可能需要进行肠切除。临床医生提高认识可以改善类似病例的治疗结果并减少并发症。
