Images in Clinical Medicine
Gallstone Ileus
N Engl J Med 2004; 351:1119September 9, 2004
- Article
An 83-year-old woman was hospitalized with nausea, vomiting, and obstipation. She had been losing weight for six months and had had similar, though less severe, symptoms during that time. She had no history of abdominal surgery and no other medical problems. The physical examination revealed a distended abdomen, with no palpable masses and no hernias. To distinguish an ileus from a mechanical small-bowel obstruction, enhanced computed tomography of the abdomen and pelvis was performed. Numerous distended loops of small intestine (Panel A, arrows), air in the biliary tree (Panel B, arrow), and a calcified intraluminal mass (Panel C, arrow) were identified. These findings established the diagnosis of gallstone ileus. The patient underwent a laparotomy with enterolithotomy, and the gallbladder was left in place. The patient had a full recovery.
John S. Graham, M.D.
Rockyview General Hospital, Calgary, AB T2V 1P9, CanadaBruce C. Rothwell, M.D.
Calgary General Hospital, Calgary, AB T1Y 6J4, Canada- Citing Articles (1)
Citing Articles
1
Ina Zuber-Jerger, Frank Kullmann, Arno Schneidewind, Jürgen Schölmerich. (2005) Diagnosis and treatment of a patient with gallstone ileus. Nature Clinical Practice Gastroenterology & Hepatology 2:7, 331-335
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