Abstract
Safra taşı ileusu kolelitiyazisin nadir karşılaşılan bir komplikasyonudur. Bu olgu sunumunda kolesistoduodenal fistül sonrasında safra taşına bağlı ileus gelişen bir olgunun direkt grafi ve bilgisayarlı tomografi bulguları sunulmuştur. Direkt grafide pnömobilia ve ince bağırsaklarda dilatasyon saptandı. Bilgisayarlı tomografi incelemesinde safra kesesinde, intrahepatik safra yollarında ve koledokta gaz, ileumda 5x3 cm. boyutlarında taş, taşın proksimalindeki ince bağırsak segmentlerinde dilatasyon ve kolesistoduodenal fistül saptandı. Yapılan enterotomi ile taş çıkarıldı. İnce barsak ve fistül onarıldı, kolesistektomi gerçekleştirildi. Bu olgu sunumu, safra taşı ileusunda, biliyer-enterik fistül düzeyi ile taş düzeyinin saptanmasında bilgisayarlı tomografinin tanısal duyarlılığını vurgulamaktadır
References
- Richards WO, Williams LF. Obstruction of the large and small intestine. Surg Clin North Am 1988; 68: 355-76.
- Abou-Saif A, Al-Kawas FH. Complications of gallstone disease: Mirizzi syndrome, cholecystocholedochal fistula, and gallstone ileus. Am J Gastroenterol 2002; 97: 249-54.
- Lobo DN, Jobling JC, Balfour TW. Gallstone ileus: diagnostic pitfalls and therapeutic successes. J Clin Gastroenterol 2000; 30: 72-6.
- Newman HF, Northup JD, Rosenblum M, Abrams H. Complications of cholelithiasis. Am J Gastroenterol 1968; 50: 476-96.
- Reisner RM, Cohen JR: Gallstone ileus: a review of 1001 reported cases. Am Surg 1994; 60: 441-46.
- Lassandro F, Romano S, Ragozzino A, Rossi G, Valente T, Ferrara I, et al. Role of helical CT in diagnosis of gallstone ileus and related conditions. AJR 2005; 185: 1159-65.
- Balthazar EJ, Schechter LS. Air in Gallbladder: A Frequent Finding in Gallstone lleus. Am J Roentgenol 1978; 131:219-22.
- Clavien PA, Richon J, Burgan S, Rohner A. Gallstone ileus. Br J Surg 1990; 77: 737-42.
- Deitz DM, Standage BA, Pinson CW, McConnell DB, Krippaehne WW. Improving the outcome in gallstone ileus. Am J Surg 1986; 151: 572-76.
- Syme RG. Management of gallstone ileus. Can J Surg 1989; 32: 61-4.
Abstract
Gallstone ileus is a rare complication of cholelithiasis. We report a case of gallstone ileus due to cholecystoduodenal fistula with the corresponding plain x-rays and computerized tomography findings. The plain x-ray film showed pneumobilia and small bowel dilatation. Computerized tomography demonstrated pneumobilia involving the common hepatic and common bile ducts, cholecystoduodenal fistula, a 5x3 cm calcified stone in the ileum and small bowel dilatation. At operation, a stone obstructing the ileum was found and it was removed via an enterotomy. Furthermore a cholecystoduodenal fistula was detected and it was primarily repaired after performance of a cholecystectomy. The aim of this report is to accentuate the sensitivity of computerized tomography examination in the determination of the location of the bilioenteric fistula and the stone in gallstone ileus
References
- Richards WO, Williams LF. Obstruction of the large and small intestine. Surg Clin North Am 1988; 68: 355-76.
- Abou-Saif A, Al-Kawas FH. Complications of gallstone disease: Mirizzi syndrome, cholecystocholedochal fistula, and gallstone ileus. Am J Gastroenterol 2002; 97: 249-54.
- Lobo DN, Jobling JC, Balfour TW. Gallstone ileus: diagnostic pitfalls and therapeutic successes. J Clin Gastroenterol 2000; 30: 72-6.
- Newman HF, Northup JD, Rosenblum M, Abrams H. Complications of cholelithiasis. Am J Gastroenterol 1968; 50: 476-96.
- Reisner RM, Cohen JR: Gallstone ileus: a review of 1001 reported cases. Am Surg 1994; 60: 441-46.
- Lassandro F, Romano S, Ragozzino A, Rossi G, Valente T, Ferrara I, et al. Role of helical CT in diagnosis of gallstone ileus and related conditions. AJR 2005; 185: 1159-65.
- Balthazar EJ, Schechter LS. Air in Gallbladder: A Frequent Finding in Gallstone lleus. Am J Roentgenol 1978; 131:219-22.
- Clavien PA, Richon J, Burgan S, Rohner A. Gallstone ileus. Br J Surg 1990; 77: 737-42.
- Deitz DM, Standage BA, Pinson CW, McConnell DB, Krippaehne WW. Improving the outcome in gallstone ileus. Am J Surg 1986; 151: 572-76.
- Syme RG. Management of gallstone ileus. Can J Surg 1989; 32: 61-4.
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Case Report |
| Authors | |
| Publication Date | September 1, 2010 |
| Published in Issue | Year 2010Issue: 3 |