Ultrasonography in gallstone ileus: a diagnostic challenge

Abstract

Objective: To describe our experience with ultrasound diagnosis of gallstone ileus in six cases, and to assess the impact of our findings in the light of published reports.

Design: Open study.

Setting: Teaching hospital, Sweden.

Subjects: Six patients with gallstone ileus.

Intervention: Abdominal ultrasound examination. MAIN OUTCOME MEASURES--Correlation with plain abdominal films and with findings at laarotomy.

Results: In all six cases ultrasound gave a precise diagnosis of gallstone ileus, together with the exact location of the gallstone, whereas plain films usually indicated only intestinal obstruction of unknown cause. There was not mortality and only one postoperative complication, and all patients were alive and well at the time they were last seen. These results compare well with those of other reported series.

Conclusion: The high morbidity and mortality of gallstone ileus may be reduced if ultrasonography is used in cases of undiagnosed abdominal pain, particularly in elderly patients with protracted symptoms.