Colonic Gallstone Ileus: the Rolling Stones

Overview

Journal BMJ Case Rep

Specialty General Medicine

Date 2014 Oct 18

PMID 25323275

Citations 9

Authors

Roisin Mary Heaney

Affiliations

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Abstract

Gallstone ileus is a rare complication of cholelithiasis accounting for 1-4% of cases of intestinal obstruction with a predominance in the elderly population. Unfortunately, it has an insipid presentation and is associated with significant rates of morbidity and mortality. Controversy arises over the management of gallstone ileus, and while surgery remains the mainstay of treatment, the main point of contention surrounds the extent of surgery. We describe the case of an 85-year-old woman who presented with symptoms and signs of large bowel obstruction. Radiological evaluation revealed a 5 cm×3.5 cm gallstone impacted in the sigmoid colon. A laparoscopic-assisted enterolithotomy alone relieved the obstruction with minimal surgical insult and allowed for a swift and uneventful recovery. Our case emphasises the need for a high index of suspicion for the condition as well as highlighting the advantages of the use of laparoscopic surgery in an emergency setting.

Citing Articles

Endoscopic laser lithotripsy of obstructive colonic gallstone ileus.

Aryan M, Sanchez-Luna S, Rapaka B, Ahmed A, Peter S, Kabir Baig K VideoGIE. 2025; 10(2):160-162.

PMID: 40012900 PMC: 11852386. DOI: 10.1016/j.vgie.2024.10.003.

Colonic Perforation Secondary to Gallstone Impaction in the Sigmoid Colon.

Gavriilidis P, Paily A Case Rep Surg. 2023; 2023:9986665.

PMID: 37521369 PMC: 10374380. DOI: 10.1155/2023/9986665.

Colonic gallstone ileus: a systematic literature review with a diagnostic-therapeutic algorithm.

Augustin G, Bruketa T, Kunjko K, Romic I, Mikus M, Vrbanic A Updates Surg. 2023; 75(5):1071-1082.

PMID: 37209317 DOI: 10.1007/s13304-023-01537-0.

Gallstone ileus of the sigmoid colon caused by cholecystocolonic fistula: A case report.

Mauricio G, David Eugenio H, Enrique Q Ann Med Surg (Lond). 2018; 31:25-28.

PMID: 29922464 PMC: 6004734. DOI: 10.1016/j.amsu.2018.06.001.

A systematic review of gallstone sigmoid ileus management.

Farkas N, Kaur V, Shanmuganandan A, Black J, Redon C, Frampton A Ann Med Surg (Lond). 2018; 27:32-39.

PMID: 29511540 PMC: 5832643. DOI: 10.1016/j.amsu.2018.01.004.

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