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Case Reports
. 2014 Nov 19:2014:bcr2014208167.
doi: 10.1136/bcr-2014-208167.

Enterolithotomy for the treatment of large bowel obstruction secondary to gallstones

Kate Swarbrick  1 , Benjamin Allin  2 , Trevor Yeung  3 , Marianne Sampson  3
Affiliations
Case Reports

Enterolithotomy for the treatment of large bowel obstruction secondary to gallstones

Kate Swarbrick et al. BMJ Case Rep. .

Abstract

We describe the case of an 81-year-old woman with large bowel-obstruction caused by an impacted gallstone. An 81-year-old, Caucasian, fully independent woman without significant comorbidities presented with absolute constipation, faecal vomiting and abdominal pain. Abdominal radiography revealed dilated small bowel, and a subsequent contrast CT demonstrated a 2.5 cm gallstone in the sigmoid colon. This is believed to have entered the transverse colon via a cholecyst-colonic fistula, and then migrated to a section of sigmoid colon affected by diverticular disease, where it became impacted. Two sigmoidoscopic removals were attempted but were unsuccessful as the gallstone's size prevented removal with an endoscopic basket. A laparotomy was performed and the stone extracted via a sigmoid enterotomy. No covering stoma was formed, and following 48 h on intensive trauma unit and a short ward-based stay for rehabilitation, the patient was discharged home and is currently doing well.

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Figures

Figure 1
Figure 1
Abdominal radiograph showing dilated loops of small bowel with an opacity within the pelvis.
Figure 2
Figure 2
Coronal CT slice showing 2.5 cm gallstone in the sigmoid colon.
Figure 3
Figure 3
Axial CT imaging revealing 2.5 cm gallstone in the sigmoid colon.
Figure 4
Figure 4
The offending gallstone after removal via sigmoid enterolithotomy.
See this image and copyright information in PMC

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