title: Role of helical CT in diagnosis of gallstone ileus and related conditions.
abstract: OBJECTIVE
  Small-bowel obstruction from gallstone impaction is a pathological entity frequently observed in elderly patients with a history of cholelithiasis or cholecystitis. Diagnostic imaging plays a great role in the management of patients with suspected gallstone ileus and overall in the correct predictive diagnosis: in the last years, some experiences in radiologic diagnosis of this entity by sonography, abdominal plain film and CT, and occasionally MRI have been reported. Some questions related to gallstone ileus are to be considered: one of them is the possibility of recurrence, which increases the operatory risk in these patients. Recurrence may be due either to the presence of overlooked stones that were already in the bowel at the time of surgery but not identified and not removed or to the migration of other stones in patients not previously cholcystectomized. In cases of acute abdomen, establishing an effective conservative therapy may be a critical point. The aim of this retrospective study was to evaluate the capabilities of helical single-detector and MDCT scanners to allow a correct diagnosis of this disease.
  
  
  CONCLUSIONS
  Helical single-detector and MDCT may improve the diagnosis of gallstone ileus, providing important information regarding the exact number, size, and location of ectopic stones and the site of intestinal obstruction or direct visualization of a biliary-enteric fistula, to help clinicians in the therapeutic management of patients.
authors.affiliation: Department of Diagnostic Imaging, A. Cardarelli Hospital, Viale Cardarelli 9, Naples 80131, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Lassandro
authors.forename: Stefania
authors.initials: S
authors.lastname: Romano
authors.forename: Alfonso
authors.initials: A
authors.lastname: Ragozzino
authors.forename: Giovanni
authors.initials: G
authors.lastname: Rossi
authors.forename: Tullio
authors.initials: T
authors.lastname: Valente
authors.forename: Ilaria
authors.initials: I
authors.lastname: Ferrara
authors.forename: Lugia
authors.initials: L
authors.lastname: Romano
authors.forename: Roberto
authors.initials: R
authors.lastname: Grassi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D042882:Gallstones / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D045823:Ileus / Q000000981:diagnostic imaging* / Q000209:etiology; D007412:Intestinal Fistula / Q000000981:diagnostic imaging / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D036542:Tomography, Spiral Computed / Q000379:methods*