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Gallstone ileus

Case contributed by Dr Domenico Nicoletti

Presentation

Abdominal pain with nausea and vomiting.

Patient Data

Age: 85
Gender: Female
CT

Obstruction of proximal ileum secondary to impaction of a gallstone with distension of the upstream loops.

There is gallbladder fistula with the duodenum and in the gallbladder gas is present.

There is also modest peritoneal effusion.

Case Discussion

The fistula is a consequence of a chronic inflammatory process of the gallbladder mucosa secondary to mechanical - ischemating action by decubitus and erosive by friction - of a voluminous calculus or a macro-aggregate of calculations. More rare is neoplastic etiology and the fistulization in gallbladder of a duodenum peptic ulcer is very rare.

Case courtesy Dr.ssa Elena Zanni

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Case information

rID: 63496
Published: 5th Oct 2018
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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