Gallstone Ileus
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《新英格兰医药杂志》
An 83-year-old woman was hospitalized with nausea, vomiting, and obstipation. She had been losing weight for six months and had had similar, though less severe, symptoms during that time. She had no history of abdominal surgery and no other medical problems. The physical examination revealed a distended abdomen, with no palpable masses and no hernias. To distinguish an ileus from a mechanical small-bowel obstruction, enhanced computed tomography of the abdomen and pelvis was performed. Numerous distended loops of small intestine (Panel A, arrows), air in the biliary tree (Panel B, arrow), and a calcified intraluminal mass (Panel C, arrow) were identified. These findings established the diagnosis of gallstone ileus. The patient underwent a laparotomy with enterolithotomy, and the gallbladder was left in place. The patient had a full recovery.
John S. Graham, M.D.
Rockyview General Hospital
Calgary, AB T2V 1P9, Canada
Bruce C. Rothwell, M.D.
Calgary General Hospital
Calgary, AB T1Y 6J4, Canada
John S. Graham, M.D.
Rockyview General Hospital
Calgary, AB T2V 1P9, Canada
Bruce C. Rothwell, M.D.
Calgary General Hospital
Calgary, AB T1Y 6J4, Canada