title: Acute intestinal obstruction due to gallstone ileus.
abstract: OBJECTIVE
  To perform a systematic review of the history, available image exams and clinical approach to the diagnosis and treatment of gallstone ileus.
  
  
  METHODS
  Retrospective study in a university hospital including all cases of SBO treated over a period of 23 years. According to the surgical treatment the patients were divided into two groups: (1) enterolithotomy with cholecystectomy performed later (two-stage surgery); and (2) enterolithotomy, cholecystectomy and fistula closure (one-stage surgery).
  
  
  RESULTS
  Twelve patients were included in the study, including 11 females (91,6%), with a mean age of 72.2 years. All patients presented associated diseases, mainly arterial hypertension (75%). All except one patient had multiple SBO symptoms. Gallstone ileus diagnosis was achieved in six patients (50%) before laparotomy. There were 8 patients in group 1 and 4 in group 2, and the morbidity was, respectively, 33.3% and 8.3%. Overall mortality was 16.6% (one patient in each group).
  
  
  CONCLUSIONS
  Gallstone ileus should be suspected in the elderly with SBO symptoms. Early diagnosis can reduce post-operative complications. Treatment is urgent laparotomy, and surgical treatment must be individualized for each case. The majority of patients in this study were treated with enterolithotomy, with cholecystectomy being performed later in two symptomatic patients.
authors.forename: Márcia Cristina
authors.initials: MC
authors.lastname: de Alencastro
authors.forename: Kaio Toledo
authors.initials: KT
authors.lastname: Cardoso
authors.forename: Cecília Araújo
authors.initials: CA
authors.lastname: Mendes
authors.forename: Yuri Longatto
authors.initials: YL
authors.lastname: Boteon
authors.forename: Rodrigo Barros
authors.initials: RB
authors.lastname: de Carvalho
authors.forename: Gustavo Pereira
authors.initials: GP
authors.lastname: Fraga
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D042882:Gallstones / Q000150:complications*; D006801:Humans; D045823:Ileus / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies