2017 Volume 48 Issue 1 Pages 3-10
We reported two cases of gallstone ileus, a relatively rare complication of cholelithiasis. Case 1 was a 78-year-old woman who presented with 3-day history of vomiting. Computed tomography (CT) scan showed emphysema of the intrahepatic bile duct, a lithoid foreign body in the small intestine, and adoral intestinal dilatation. Thus, gallstone ileus was diagnosed. Case 2 was a 71-year-old woman who presented with 2-day history of nausea and vomiting. CT scan showed no gallstone, but emphysema of the gallbladder, a lithoid foreign body in the small intestine, and adoral intestinal dilatation, which indicated gallstone ileus. The both cases were accompanied by renal dysfunction due to dehydration. As retained calculus was not found in the gallbladder, we performed surgery only for dissolution of ileus with removal of the calculus through a small incision on the intestine. The postoperative course was good in both patients. For gallstone ileus, decision of surgery, stone removal with or without cholecystectomy, should be based on the patient’s status, retained gallstones and persistent fistula. We herein discuss on the surgical treatment for gallstone ileus with an analysis of the 52 reported cases for the past 5 years in Japan.
