title: The oldest patient with gallstone ileus: report of a case and review of 176 cases in Japan.
abstract: We report a 91-year-old woman presenting bowel obstruction due to impacted gallstone, who was the oldest patient which has been reported in Japanese scientific literature. The patient was referred to our hospital due to vomiting and abdominal pain. Computed tomography and abdominal X-ray showed dilated loops of small intestine associated with air-fluid levels, pneumobilia, and a calcified mass in the left iliac fossa. After the diagnosis of bowel obstruction due to gallstone was made, an enterotomy and lithotomy was performed under spinal anesthesia. The postoperative recovery was uneventful. We also reviewed 176 cases of gallstone ileus which were reported in the Japanese literature in the past 20 years. The retrospective analysis demonstrated that one-stage enterolithotomy alone may be acceptable as the first choice of operative treatment. The gallstone ileus is a rare, but important disease because urgent and appropriate surgical therapy is required.
authors.affiliation: Department of Gastroenterology, Hepatology and Diabetes Mellitus Center, Fujita Hospital. anakao@imap.pitt.edu
authors.forename: Atsunori
authors.initials: A
authors.lastname: Nakao
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Okamoto
authors.forename: Masataka
authors.initials: M
authors.lastname: Sunami
authors.forename: Takuji
authors.initials: T
authors.lastname: Fujita
authors.forename: Takao
authors.initials: T
authors.lastname: Tsuji
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D042882:Gallstones / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D045823:Ileus / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D007564:Japan; D008297:Male; D012189:Retrospective Studies