title: Gallstone ileus of the sigmoid colon: an extremely rare cause of large bowel obstruction detected by multiplanar CT.
abstract: Gallstone ileus of the sigmoid colon is an important, though extremely rare, cause of large bowel obstruction. The gallstone often enters the large bowel through a fistula formation between the gallbladder and colon, and impacts at a point of narrowing, causing large bowel obstruction. We describe the case of an 80-year-old woman who presented with features of bowel obstruction. Multiplanar abdominal CT demonstrated a cholecystocolonic fistula in exquisite detail. The scan also showed obstruction of the colon due to a large gallstone impacted just proximal to a stricture in the sigmoid. Owing to inflammatory adhesions and a stricture from extensive diverticular disease, the gallstone could not be retrieved. This frail and elderly woman was treated with a loop colostomy to relieve bowel obstruction. The patient made an uneventful recovery.
authors.affiliation: North Bristol Trust, Southmead Hospital, Bristol, UK.
authors.forename: Tarryn
authors.initials: T
authors.lastname: Carlsson
authors.affiliation: North Bristol Trust, Southmead Hospital, Bristol, UK.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Gandhi
mesh_terms: D000369:Aged, 80 and over; D003125:Colostomy; D003251:Constriction, Pathologic / Q000150:complications; D004239:Diverticulitis, Colonic / Q000150:complications; D005260:Female; D005705:Gallbladder Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D042882:Gallstones / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D007412:Intestinal Fistula / Q000150:complications / Q000000981:diagnostic imaging*; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D012810:Sigmoid Diseases / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D014057:Tomography, X-Ray Computed