Reasoned diagnostic approach to a case of small bowel obstruction.
The case of a 73-year-old male patient come to the Emergency Department for epigastric pain, vomiting and blocked bowel movement is presented. Plain abdominal X-ray performed on emergency showed marked small bowel distention, and air-fluid levels suggestive of intestinal obstruction. CT was indicated to establish its precise site and cause. The presence of a gallstone was evidenced: gallstone ileus was diagnosed. Interestingly enough, at surgery the gallstone was not found; most likely it was expelled spontaneuously during the time elapsed between CT and surgery. Based on imaging findings and a review of the literature it was concluded that the study patient had a rare association of intestinal volvulus and gallstone ileus.
Stamati
Giovanni
G
Istituto di Radiologia, Università Cattolica del S. Cuore, Policlinico "A. Gemelli", Roma, Italy.
Ierardi
Anna Maria
AM
Minordi
Laura Maria
LM
Cina
Alessandro
A
Meduri
Agostino
A
Vecchioli
Amorino
A
D000368:Aged; D002769:Cholelithiasis / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D007077:Ileal Diseases / Q000175:diagnosis* / Q000601:surgery; D007415:Intestinal Obstruction / Q000209:etiology* / Q000601:surgery; D008297:Male