Abstract
Gallstone ileus is a rare complication of cholelithiasis, which has been supposed to be difficult to diagnose preoperatively. This paper describes a case of gallstone ileus successfully diagnosed preoperatively, with a review of 130 cases in the Japanese literature for the last 11 years.
A 79-year-old woman was hespitalized into the hospital because of abdominal pain. Abdominal simple X-ray films revealed that an oval-shaped calcificated gallstone passed into the upper intestine, and several days later, it packed into the ileum and caused obstruction of the ileum. Laparotomy was performed under a diagnosis of gallstone ileus 24 days after admission. The impacted stone (5×3cm) was removed through enterotomy and no biliary radical operation was carried out.
It is known that this disease has been first diagnosed at laparotomy in most cases with a high operative mortality. Cumulated 130 cases reported in the Japanese literature since 1980, however, has indicated that the preoperative correct diagnosing rate is increasing and operative deaths are decreasing.
