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KMID : 0828520140180040246
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Journal of the Korean Geriatrics Society
2014 Volume.18 No. 4 p.246 ~ p.250
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Gallstone Ileus in 83-Year-Old Woman
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Oh Song-Hee
Jo Jun-Ho
Kim Il-Soo
Kim Woo-Young
Park Kun-Woo
Jung Min-Woong
Park Jong-Ik
Park Se-Ryeong
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Abstract
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Gallstone ileus is a rare complication of the biliary stone, occurring in 0.3-0.5% of patients with cholelithiasis. The mortality rate is high at 12-27% and early diagnosis and prompt management can improve its prognosis. An 83-yearold woman was admitted to the hospital with abdominal pain. The patient previously had a hysterectomy and had received radiation therapy for uterine cancer. Plain abdominal x-ray showed typical findings of small bowel ileus with step ladder patterns. Computed tomography (CT) scan revealed biliary-enteric fistula with a 3-cm-sized gallstone in the jejunal loop. Surgical treatment was planned but due to the patient’s wish, conservative treatment was provided for 10 days. In the follow-up CT scan, the stone had moved to the distal ileum but intestinal perforation was suspected. Ileocecectomy and adhesiolysis were performed and the patient recovered fully. Here we report a case of gallstone ileus that was treated by surgical removal after 10 days of conservative treatment.
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KEYWORD
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Gallstones, Ileus, Intestinal perforation
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