GALLSTONE ILEUS WITH CHOLECYSTO-DUODENAL FISTULA IN AN ELDERLY MALE

Authors

  • Said Umer National Hospital & Medical Centre, Lahore, Pakistan
  • Usman Ismat Butt National Hospital & Medical Centre, Lahore, Pakistan
  • Asad Ali Toor Cork University Hospital, Wilton, County Cork, Republic of Ireland
  • Zeeshan Razzaq Cork University Hospital, County Cork, Republic of Ireland
  • Muhammad Waris Farooka National Hospital & Medical Centre, Lahore, Pakistan
  • Shazia Noreen Cork University Hospital, Wilton, County Cork, Republic of Ireland
  • Abeeda Butt Cork University Hospital, Wilton, County Cork, Republic of Ireland
  • Henry Paul Redmond Cork University Hospital, Wilton, County Cork, Republic of Ireland

Abstract

Gall stone ileus associated with cholecysto-duodenal fistula is a rare pathology. It most commonly presents in elderly females in 72–90% of cases. In such a case, a patient typically presents with recurrent attacks of sub-acute intestinal obstruction which usually resolves completely with conservative management only to recur again after some time. We are reporting a case of an 85-year-old gentleman who presented to us with gallstone ileus associated with cholecysto-duodenal fistula and his subsequent management. He underwent Laparotomy with enterotomy, stone extraction, Cholecystectomy and Graham’s patch repair of the fistula. The purpose of this case report is to discuss a rare case of gall stone ileus associated with cholecysto-duodenal fistula. The diagnosis was confirmed using imaging and appropriate and timely surgical intervention for both mechanical intestinal obstruction and the fistula was undertaken.Keywords: Gallstone ileus; Pneumo-bilia; Abdominal X-ray

Author Biographies

Said Umer, National Hospital & Medical Centre, Lahore, Pakistan

PGR, Department of General Surgery, National Hospital & Medical Centre, Lahore, Pakistan

Usman Ismat Butt, National Hospital & Medical Centre, Lahore, Pakistan

Senior Registrar, Department of General Surgery, National Hospital & Medical Centre, Lahore, Pakistan

Asad Ali Toor, Cork University Hospital, Wilton, County Cork, Republic of Ireland

Registrar General Surgery, Cork University Hospital, Wilton, County Cork, Republic of Ireland

Zeeshan Razzaq, Cork University Hospital, County Cork, Republic of Ireland

Senior Registrar, General Surgery, Cork University Hospital, County Cork, Republic of Ireland

Muhammad Waris Farooka, National Hospital & Medical Centre, Lahore, Pakistan

Associate Professor General Surgery, National Hospital & Medical Centre, Lahore, Pakistan

Shazia Noreen, Cork University Hospital, Wilton, County Cork, Republic of Ireland

Registrar General Surgery, Cork University Hospital, Wilton, County Cork, Republic of Ireland

Abeeda Butt, Cork University Hospital, Wilton, County Cork, Republic of Ireland

Senior Registrar General Surgery, Cork University Hospital, Wilton, County Cork, Republic of Ireland

Henry Paul Redmond, Cork University Hospital, Wilton, County Cork, Republic of Ireland

Professor & Chair of Department of Surgery, Cork University Hospital, Wilton, County Cork, Republic of Ireland

References

Stinton LM, Shaffer EA. Epidemiology of gallbladder disease: cholelithiasis and cancer. Gut Liver 2012;6(2):172–87.

Brazzelli M, Cruickshank M, Kilonzo M, Ahmed I, Stewart F, McNamee P, et al. Clinical effectiveness and cost-effectiveness of cholecystectomy compared with observation/conservative management for preventing recurrent symptoms and complications in adults presenting with uncomplicated symptomatic gallstones or cholecystitis: a systematic review and economic evaluation. Health Technol Assess 2014;18(55):1–101,v–vi.

Halldestam I, Enell EL, Kullman E, Borch K. Development of symptoms and complications in individuals with asymptomatic gallstones. Br J Surg 2004;91(6):734–8.

Reisner RM, Cohen JR. Gallstone ileus: a review of 1001 reported cases. Am Surg 1994;60(6):441–6.

Nakao A, Okamoto Y, Sunami M, Fujita T, Tsuji T. The oldest patient with gallstone ileus: report of a case and review of 176 cases in Japan. Kurume Med J 2008;55(1-2):29–33.

Liang X, Li W, Zhao B, Zhang L, Cheng Y. Comparative analysis of MDCT and MRI in diagnosing chronic gallstone perforation and ileus. Eur J Radiol 2015;84(10):1835–42.

Key A, Dawkins A, DiSantis D. Rigler's Triad. Abdom Imaging 2015;40(1):229–30.

Negi RS, Chandra M, Kapur R. Bouveret syndrome: Primary demonstration of cholecystoduodenal fistula on MR and MRCP study. Indian J Radiol Imaging 2015;25(1):31–4.

Chong VH, Lim KS, Mathew VV. Spontaneous gallbladder perforation, pericholecystic abscess and cholecystoduodenal fistula as the first manifestations of gallstone disease. Hepatobiliary Pancreat Dis Int 2009;8(2):212–4.

Dash N. Successful laparoscopic management of four cases of cholecystoduodenal fistula. Med J Armed Forces India 2012;68(1):88–9.

Latic A, Latic F, Delibegovic M, Samardzic J, Kraljik D, Delibegovic S. Succcessful laparoscopic treatment of cholecystoduodenal fistula. Med Arh 2010;64(6):379–80.

Ozkan A, Ozaydin I, Kaya M, Kucuk A, Katranci AO. Malrotation-associated cholecystoduodenal fistula. Am J Case Rep 2014;15:18–21.

Faridi MS, Pandey A. Mirizzi Syndrome Type II with Cholecystoduodenal Fistula: An Infrequent Combination. Malays J Med Sci 2014;21(1):69–71.

Takata H, Yoshida H, Hirakata A, Watanabe M, Uchida E, Uchida E. Recurrent Gallstone Ileus Successfully Treated with Conservative Therapy. J Nippon Med Sch 2015;82(6):300–3.

Shioi Y, Kawamura S, Kanno K, Nishinari Y, Ikeda K, Noro A, et al. A case of gallstone ileus displaying spontaneous closure of cholecystoduodenal fistula after enterolithotomy. Int J Surg Case Rep 2012;3(1):12–5.

Shiwani MH, Ullah Q. Laparoscopic enterolithotomy is a valid option to treat gallstone ileus. JSLS 2010;14(2):282–5.

Owera A, Low J, Ammori BJ. Laparoscopic enterolithotomy for gallstone ileus. Surg Laparosc Endosc Percutan Tech 2008;18(5):450–2.

Downloads

Published

2018-11-27

Most read articles by the same author(s)