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. 2015:13:12-4.
doi: 10.1016/j.ijscr.2015.06.003. Epub 2015 Jun 3.

Recurrent gallstone ileus due to a residual gallstone: A case report and literature review

J R Apollos  1 , R V Guest  2
Affiliations

Recurrent gallstone ileus due to a residual gallstone: A case report and literature review

J R Apollos et al. Int J Surg Case Rep. 2015.

Abstract

Introduction: Mechanical small bowel obstruction is an uncommon but important complication of cholelithiasis. Recurrent gallstone ileus has historically been considered a rare occurrence; however, the incidence is likely to be underreported and the condition carries a high mortality rate.

Presentation of case: We present a case in which a 67 year old man suffered a recurrence of gallstone ileus 10 days after his initial enterolithotomy, requiring further laparotomy.

Discussion: We review the literature to highlight potential clinical predictors as well as the benefits and pitfalls of management options in preventing repeated episodes of gallstone ileus in the same patient.

Conclusion: The presence of multifaceted gallstones and multiple stones of size≥2cm on pre-operative imaging should alert the clinician to potential for recurrence.

Keywords: Enterolithotomy; Gallstone ileus; Recurrence.

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Figures

Fig. 1
Fig. 1
(A) Coronal CT image obtained at initial presentation showing acute cholecystitis (filled arrow) and an ischaemic segment of small bowel (filled arrow). (B) Coronal CT image obtained on the tenth post-operative day demonstrating pneumobilia (filled arrow) and small bowel obstruction secondary to a second gallstone (filled arrow). (C) Historical axial CT image demonstrating two 2 cm faceted gallstones within the gallbladder.
Fig. 2
Fig. 2
Operative specimen of resected segment of ischaemic distal jejunum with patchy necrosis and a retrieved faceted gallstone.
See this image and copyright information in PMC

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