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. 2018:49:51-54.
doi: 10.1016/j.ijscr.2018.06.015. Epub 2018 Jun 23.

Sigmoid gallstone ileus: A case report and literature review in Japan

Koichi Inukai  1 , Shuhei Uehara  2 , Hirotaka Miyai  2 , Nobuhiro Takashima  2 , Minoru Yamamoto  2 , Kenji Kobayashi  2 , Moritsugu Tanaka  2 , Tetsushi Hayakawa  3
Affiliations

Sigmoid gallstone ileus: A case report and literature review in Japan

Koichi Inukai et al. Int J Surg Case Rep. 2018.

Abstract

Introduction: Gallstone as a cause of bowel obstruction is rare, and its occurrence in the colon is very infrequent. Here, we report the case of sigmoid gallstone ileus treated with one-stage operation.

Case presentation: A 65-year-old man visited our hospital because of abdominal pain and nausea. On the basis of the results of computed tomography, the patient was diagnosed with sigmoid gallstone ileus through cholecystocolonic fistula, and an emergency laparotomy was performed. Enterolithotomy, cholecystectomy, and fistula closure were performed in one-stage operation. Postoperatively, the patient developed biliary leakage, which rapidly recovered with conservative therapy.

Discussion and conclusion: The surgical treatment of gallstone ileus remains controversial. For postoperative infection control, one-stage operation can be considered for patients with gallstone ileus associated with cholecystocolonic fistula.

Keywords: Gallstone ileus; One-stage operation; Sigmoid obstruction.

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Figures

Fig. 1
Fig. 1
Plain abdominal radiograph showing air bowel distention in the upper abdomen and a round opacity in the left lower abdomen (arrow).
Fig. 2
Fig. 2
Computed tomography (CT) images. CT image showing (a) cholecystocolic fistula (arrow) connecting the gallbladder to the transverse colon, (b) a calculus mass impacted in the sigmoid colon, and (c) left inguinal hernia (arrow).
Fig. 3
Fig. 3
Removal of gallstones from the sigmoid colon.
Fig. 4
Fig. 4
Intraoperative findings. The cholecystocolonic fistula was released. The arrow indicates the fistula on the colonic side.
See this image and copyright information in PMC

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