Abstract
We encountered a case of gallbladder carcinoma with subserosal invasion that presented as gallstone ileus, and report it here with a literature review. The patient was a 79-year-old man. He consulted another hospital with chief complaints of vomiting and abdominal pain. After emergency admission, he failed to improve with conservative management, so he transferred to our hospital on October 21,2003. We inserted an ileus tube, and recognized a bird's beak sign in the small intestine. Therefore, an emergency operation was done under the diagnosis of intussusception. A hard mass that entered the ileocecal valve with 100 cm of small intestine was detected at operation, and this lesion was resected. A gallstome with a diameter of 4 × 2.8 cm was found in the resected specimen. We also performed cholecystectomy and placed an ()mental patching after trimming the wall of the duodenum to close a cholecystoduodenal fistula. Postoperative pathological examination of the resected material gave a diagnosis of carcinoma of the gallbladder. We have followed up this patient because of his old age and ischemic heart disease, although we suggested an additional operation.
