Gallstone impacted in the rectosigmoid junction causing a biliary ileus and a sigmoid perforation.
A gallstone ileus is an unusual form of bowel obstruction. Colonic gallstone ileus is rare, difficult to diagnose, and still has a high mortality rate. We present a case of biliary ileus caused by an impacted gallstone, causing necrosis and perforation of the rectosigmoid junction. A Hartmann's procedure was performed to treat the perforation and the obstruction. Cholecystectomy and closure of the cholecysto-colonic fistula were delayed until restoration of the intestinal continuity.
Van Kerschaver
O
O
Sint Lucas, Gent, Belgium.
Van Maele
V
V
Vereecken
L
L
Kint
M
M
D000368:Aged; D002763:Cholecystectomy; D003937:Diagnosis, Differential; D042882:Gallstones / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D045823:Ileus / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D008297:Male; D014057:Tomography, X-Ray Computed