Perforated Closed-Loop Obstruction Secondary to Gallstone Ileus of the Transverse Colon: A Rare Entity
| Autor: | S. P. Carr, F. T. MacNamara, K. M. Muhammed, E. Boyle, S. M. McHugh, P. Naughton, A. Leahy |
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| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: | |
| Zdroj: | Case Reports in Surgery, Vol 2015 (2015) |
| Druh dokumentu: | article |
| ISSN: | 2090-6900 2090-6919 |
| DOI: | 10.1155/2015/691713 |
| Popis: | Introduction. Gallstone ileus (GSI) of the colon is an extremely rare entity with potentially serious complications including perforation. Case Presentation. An 88-year-old man presented to the emergency department with abdominal pain and distension. Clinical exam revealed signs of peritonism. Computed tomography (CT) revealed GSI of the transverse colon with a closed-loop large bowel obstruction (LBO) and caecal perforation. The patient underwent emergency laparotomy. A right hemicolectomy was performed, the gallstone was removed, and a primary bowel anastomosis was undertaken. A Foley catheter was sutured into the residual gallbladder bed to create a controlled biliary fistula. The patient recovered well postoperatively with no complications. He was discharged home with the Foley catheter in situ. Discussion. Gallstone ileus is a difficult diagnosis both clinically and radiologically with only 50% of cases being diagnosed preoperatively. Most commonly it is associated with impaction at the ileocaecal valve and small bowel obstruction. Gallstone ileus should also be considered as a rare but potential cause of LBO. This is the first reported case of caecal perforation secondary to gallstone ileus of the transverse colon. Successful operative management consisted of a one-stage procedure with right hemicolectomy and formation of a controlled biliary fistula. |
| Databáze: | Directory of Open Access Journals |
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