Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2021 Feb:79:470-474.
doi: 10.1016/j.ijscr.2021.01.077. Epub 2021 Jan 27.

Gallstone ileus after recent cholecystectomy. Case report and review of the literature

Uriel Martínez Segundo  1 , Antonio Pérez Sánchez  2 , María Paulina Sesman Bernal  2 , Andrea Carolina Pérez Burguete  3
Affiliations
Case Reports

Gallstone ileus after recent cholecystectomy. Case report and review of the literature

Uriel Martínez Segundo et al. Int J Surg Case Rep. 2021 Feb.

Abstract

Introduction and importance: Gallstone ileus in cholecystectomized patients is very infrequent and when it happens shortly after surgery is even rarer. We report the case of a patient who presented Gallstone ileus few days after open cholecystectomy which has not been reported before in literature.

Case presentation: A 52-year-old male with a history of recent open cholecystectomy was referred to our center due to a presumable surgical complication. During his hospitalization while trying to restart the oral route he presented abdominal pain and nausea. He evolved toward a bowel obstruction. We suspected gallstone ileus based on medical history as well as preoperative image study. We confirmed the diagnostic using a Computed Tomography. Surgical management was performed and a large gallstone was extracted from the bowel. The patient progressed favorably and was discharged. He was asymptomatic during the follow-up.

Clinical discussion: Cholecystectomized patients who have been reported with Gallstone ileus demonstrate different pathophysiological mechanisms or extraordinary presentations. This case describes a unique presentation illustrating relevant aspects of this pathology such as showing that acute cholecystitis can be its clinical manifestation or that it could happen after a cholecystoenteric fistula is found during a cholecystectomy.

Conclusion: Gallstone ileus in cholecystectomized patients is very rare. Clinical suspicion remains the cornerstone of diagnosis.

Keywords: Bouveret’s syndrome; Case report; Cholecystectomy; Cholecystoenteric fistula; Gallstone ileus; Intestinal obstruction.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
(A) Ultrasound images showing gallbladder dimensions, the presence of a gallstone and biliary sludge. (B) Gallstone’s dimensions and its acoustic shadow.
Fig. 2
Fig. 2
Preoperative Computed Tomography demonstrating a lost gallstone with calcified edges in the right hemiabdomen.
Fig. 3
Fig. 3
(A) Recent open cholecystectomy. (B) Gallstones is removed by enterolithotomy. (C) Gallstone measured.
Fig. 4
Fig. 4
Magnetic Resonance Cholangiopancretography image showing the presence of gallstone.
See this image and copyright information in PMC

References

    1. Halabi W.J., Kang C.Y., Ketana N., Lafaro K.J., Nguyen V.Q., Stamos M.J., Imagawa D.K., Demirjian A.N. Surgery for gallstone ileus: a nationwide comparison of trends and outcomes. Ann. Surg. 2014;259:329–335. doi: 10.1097/SLA.0b013e31827eefed. - DOI - PubMed
    1. Alemi F., Seiser N., Ayloo S. Gallstone disease: Cholecystitis, mirizzi syndrome, bouveret syndrome, gallstone ileus. Surg. Clin. North Am. 2019;99:231–244. doi: 10.1016/j.suc.2018.12.006. - DOI - PubMed
    1. Nuño-Guzmán C.M. Gallstone ileus, clinical presentation, diagnostic and treatment approach. World J. Gastrointest. Surg. 2016;8:65–76. doi: 10.4240/wjgs.v8.i1.65. - DOI - PMC - PubMed
    1. Ploneda-Valencia C.F., Gallo-Morales M., Rinchon C., Navarro-Muñiz E., Bautista-López C.A., de la Cerda-Trujillo L.F., Rea-Azpeitia L.A., López-Lizarraga C.R. Gallstone ileus: an overview of the literature. Rev. Gastroenterol. México (English Ed.) 2017;82:248–254. doi: 10.1016/j.rgmxen.2017.05.001. - DOI - PubMed
    1. Fedele S., Lobascio P., Carbotta G., Balducci G., Laforgia R., Sederino M.G., Minafra M., Delvecchio A., Palasciano N. Gallstone ileus in a ninety-two years old colecistectomized patient after endoscopic biliary sphincterotomy: A case report. G. Di Chir. 2017;38:299–302. doi: 10.11138/gchir/2017.38.6.299. - DOI - PMC - PubMed

Publication types