[Biliary ileus: a review of the literature and report of a clinical case treated by minilaparotomy].
OBJECTIVE
To evaluate the diagnostic and therapeutic approach to gallstone ileus.


METHODS
A gallstone ileus report, diagnosed by integrated radiological approach, treated by minilaparotomy plus enterolithotomy and followed up for two years.


RESULTS
Traditional radiologic findings, ultrasonography and computed tomography showed both the stone in the bowel lumen and the cholecystoduodenal fistula with air in the biliary tract. The enterolithotomy alone worked out the obstruction and no complication was observed.


CONCLUSIONS
Integrated radiologic examinations are indicated in defining nature, site and seriousness of gallstone ileus. In most cases surgical treatment is mandatory to work out both the bowel occlusion and bilioenteric illness even though it is often wiser to perform an operation of enterolithotomy alone owing to the general and local conditions of the patient. After this surgical approach, bilioenteric fistula disappears in most cases with no residual lithiasis; in the cases in which fistula and/or lithiasis persist, a decisive surgical operation can be performed in a second step.
Galizia
G
G
VII Divisione di Chirurgia Generale ed Epatobiliare, Facoltà di Medicina e Chirurgia, Seconda Università di Napoli. gennaro.galizia@unina2.it
Lieto
E
E
Pelosio
L
L
Imperatore
V
V
Castellano
P
P
Pignatelli
C
C
D001658:Biliary Fistula / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D002769:Cholelithiasis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D002908:Chronic Disease; D004378:Duodenal Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D005705:Gallbladder Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D006801:Humans; D007077:Ileal Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D007412:Intestinal Fistula / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D007813:Laparotomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods