Abstract
Introduction: Gallstone
ileus is described as an intestinal obstruction caused by luminal gallstone
impaction. It is a mainly geriatric disease with a prevalence of over 25 % in
the elderly population. Morbidity and mortality rates are high which are caused
due to the delayed presentation, diagnosis and treatment in comorbid patients.
Interestingly, since the past century, the optimal surgical procedure in this
type of mechanical ileus is still highly controversial and challenging.
Presentation of case: In the current paper we demonstrate our experience with a
patient treated at our institution due to gallstone ileus. During surgical
exploration the impacted stone in the terminal ileum was removed without
preforming a cholecystectomy. This decision was made because of the unstable
and septic status of the patient necessitating quick relief of the obstruction
and no signs of ongoing severe peritonitis and acute Cholecystitis. She had an
uneventful postoperative course.
Discussion & conclusion: While enterolithotomy is performed most commonly because of
the low incidence of complications, the risk of developing recurrent biliary
symptoms has led to a more aggressive approach with concomitant fistula repair
and cholecystectomy.
Keywords: Gallstone
ileus, elderly patients, surgical therapy, decision-making
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