title: Enterolithotomy for the treatment of large bowel obstruction secondary to gallstones.
abstract: We describe the case of an 81-year-old woman with large bowel-obstruction caused by an impacted gallstone. An 81-year-old, Caucasian, fully independent woman without significant comorbidities presented with absolute constipation, faecal vomiting and abdominal pain. Abdominal radiography revealed dilated small bowel, and a subsequent contrast CT demonstrated a 2.5 cm gallstone in the sigmoid colon. This is believed to have entered the transverse colon via a cholecyst-colonic fistula, and then migrated to a section of sigmoid colon affected by diverticular disease, where it became impacted. Two sigmoidoscopic removals were attempted but were unsuccessful as the gallstone's size prevented removal with an endoscopic basket. A laparotomy was performed and the stone extracted via a sigmoid enterotomy. No covering stoma was formed, and following 48 h on intensive trauma unit and a short ward-based stay for rehabilitation, the patient was discharged home and is currently doing well.
authors.affiliation: Department of Accident and Emergency, Horton General Hospital, Banbury, UK.
authors.forename: Kate
authors.initials: K
authors.lastname: Swarbrick
authors.affiliation: Neonatal Perinatal Epidemiology Unit, University of Oxford, Headington, UK.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Allin
authors.affiliation: Department of Upper GI Surgery, Royal Berkshire Hospital, Reading, UK.
authors.forename: Trevor
authors.initials: T
authors.lastname: Yeung
authors.affiliation: Department of Upper GI Surgery, Royal Berkshire Hospital, Reading, UK.
authors.forename: Marianne
authors.initials: M
authors.lastname: Sampson
mesh_terms: D000369:Aged, 80 and over; D044684:Colon, Transverse / Q000601:surgery*; D003108:Colonic Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005260:Female; D042882:Gallstones / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D014057:Tomography, X-Ray Computed