Abstract
A rare case of gallstone ileus caused by a stent-stone complex (SSC) is described. The patient was a 71-year-old female who had undergone laparoscopic cholecystectomy for cholecystolithiasis at another hospital 8 years earlier. However, a definite diagnosis of gallbladder carcinoma was made after the operation ; the patient had an additional resection of the common bile duct and hepaticojejunostomy at that time. A metal stent was placed via percutaneous transhepatic biliary drainage (PTBD) into the biliary anastomotic stricture 5 years 10 months prior to the current admission. At the time of the current admission, the patient had an ileus with upper abdominal pain and vomiting. Abdominal X-ray and computed tomography (CT) showed intestinal obstruction due to a migrated SSC from the hepaticojejunostomy. Following conservative treatment with a long intestinal tube, emergency surgery was required. Operative findings showed an impacted SSC in the ileum. Enterolithotomy was successfully performed using a small incision in the umbilical region. It is important to keep in mind that a gallstone can form around a stent after a long period of time and can then act as a nidus for a gallstone ileus.
