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Gallstone Ileus

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Emergency General Surgery

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Abstract

Gallstone ileus is a mechanical obstruction of the gastrointestinal tract caused by gallstones that enter the alimentary tract via a cholecystoenteric fistula. It occurs in less than 1% of bowel obstructions and 0.3% of patients with cholelithiasis. There is an increased rate of diagnosis in the elderly, >65 years old, with female predominance (3:1). Presentation is often delayed due to intermittent symptoms. Abdominal CT scan has supplanted both abdominal X-rays and ultrasound as the most sensitive diagnostic test of choice. While cases have been reported of successful lithotripsy with endoscopic retrieval, surgical intervention is still the gold standard of treatment. Enterolithotomy alone is the most common operation performed due to historically lower rates of mortality and morbidity, but controversy remains regarding the utility of laparoscopic approaches and interventions to address the biliary fistula (131 words).

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References

  1. Deitz DM, Standage BA, Pinson CW, McConnell DB, Krippaehne WW. Improving the outcome in gallstone ileus. Am J Surg. 1986;151(5):572–6.

    Article  CAS  PubMed  Google Scholar 

  2. Halabi WJ, Kang CY, Ketana N, Lafaro KJ, Nguyen VQ, Stamos MJ, Imagawa DK, Demirjian AN. Surgery for gallstone ileus: a nationwide comparison of trends and outcomes. Ann Surg. 2014;259(2):329–35.

    Article  PubMed  Google Scholar 

  3. Reisner RM, Cohen JR. Gallstone ileus: a review of 1001 reported cases. Am Surg. 1994;60(6):441–6.

    CAS  PubMed  Google Scholar 

  4. Clavien PA, Richon J, Burgan S, Rohner A. Gallstone ileus. Br J Surg. 1990;77(7):737–42.

    Article  CAS  PubMed  Google Scholar 

  5. van Hillo M, van der Vliet JA, Wiggers T, Obertop H, Terpstra OT, Greep JM. Gallstone obstruction of the intestine: an analysis of ten patients and a review of the literature. Surgery. 1987;101(3):273–6.

    PubMed  Google Scholar 

  6. Nuño-Guzmán CM. Gallstone ileus, clinical presentation, diagnostic and treatment approach. World J Gastrointest Surg. 2016;8(1):65–13.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Deckoff SL. Gallstone ileus; a report of 12 cases. Ann Surg. 1955;142(1):52–65.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Cooperman AM, Dickson ER, ReMine WH. Changing concepts in the surgical treatment of gallstone ileus: a review of 15 cases with emphasis on diagnosis and treatment. Ann Surg. 1968;167(3):377–83.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Ayantunde AA, Agrawal A. Gallstone ileus: diagnosis and management. World J Surg. 2007;31(6):1292–7.

    Article  CAS  PubMed  Google Scholar 

  10. Mallipeddi MK, Pappas TN, Shapiro ML, Scarborough JE. Gallstone ileus: revisiting surgical outcomes using National Surgical Quality Improvement Program data. J Surg Res. 2013;184(1):84–8.

    Article  PubMed  Google Scholar 

  11. Stinton LM, Shaffer EA. Epidemiology of gallbladder disease: cholelithiasis and cancer. Gut Liver. 2012;6(2):172–87.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Day EA, Marks C. Gallstone ileus. Review of the literature and presentation of thirty-four new cases. Am J Surg. 1975;129(5):552–8.

    Article  CAS  PubMed  Google Scholar 

  13. VanLandingham SB, Broders CW. Gallstone ileus. Surg Clin North Am. 1982;62(2):241–7.

    Article  CAS  PubMed  Google Scholar 

  14. Moss JF, Bloom AD, Mesleh GF, Deziel D, Hopkins WM. Gallstone ileus. Am Surg. 1987;53(8):424–8.

    CAS  PubMed  Google Scholar 

  15. Chou J-W, Hsu C-H, Liao K-F, Lai H-C, Cheng K-S, Peng C-Y, Yang M-D, Chen Y-F. Gallstone ileus: report of two cases and review of the literature. World J Gastroenterol. 2007;13(8):1295–8.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Masannat Y, Masannat Y, Shatnawei A. Gallstone ileus: a review. Mt Sinai J Med. 2006;73(8):1132–4.

    PubMed  Google Scholar 

  17. Rigler LG, Borman CN, Noble JF. Gallstone obstruction: pathogenesis and roentgen manifestations. J Am Med Assoc. 1941;117(21):1753–9.

    Article  Google Scholar 

  18. Balthazar EJ, Schechter LS. Air in gallbladder: a frequent finding in gallstone ileus. AJR Am J Roentgenol. 1978;131(2):219–22.

    Article  CAS  PubMed  Google Scholar 

  19. Ripollés T, Miguel-Dasit A, Errando J, Morote V, Gómez-Abril SA, Richart J. Gallstone ileus: increased diagnostic sensitivity by combining plain film and ultrasound. Abdom Imaging. 2001;26(4):401–5.

    Article  PubMed  Google Scholar 

  20. Lassandro F, Gagliardi N, Scuderi M, Pinto A, Gatta G, Mazzeo R. Gallstone ileus analysis of radiological findings in 27 patients. Eur J Radiol. 2004;50(1):23–9.

    Article  PubMed  Google Scholar 

  21. Gaduputi V, Tariq H, Rahnemai-Azar AA, Dev A, Farkas DT. Gallstone ileus with multiple stones: where Rigler triad meets Bouveret’s syndrome. World J Gastrointest Surg. 2015;7(12):394–7.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Wong CS, Crotty JM, Naqvi SA. Pneumobilia: a case report and literature review on its surgical approaches. J Surg Tech Case Rep. 2013;5(1):27–31.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Lasson A, Lorén I, Nilsson A, Nirhov N, Nilsson P. Ultrasonography in gallstone ileus: a diagnostic challenge. Eur J Surg. 1995;161(4):259–63.

    CAS  PubMed  Google Scholar 

  24. Davies RJ, Sandrasagra FA, Joseph AE. Case report: ultrasound in the diagnosis of gallstone ileus. Clin Radiol. 1991;43(4):282–4.

    Article  CAS  PubMed  Google Scholar 

  25. Yu CY, Lin CC, Shyu RY, Hsieh CB, Wu HS, Tyan YS, Hwang JI, Liou CH, Chang WC, Chen CY. Value of CT in the diagnosis and management of gallstone ileus. World J Gastroenterol. 2005;11(14):2142–7.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Kirchmayr W, Mühlmann G, Zitt M, Bodner J, Weiss H, Klaus A. Gallstone ileus: rare and still controversial. ANZ J Surg. 2005;75(4):234–8.

    Article  PubMed  Google Scholar 

  27. Lassandro F, Romano S, Ragozzino A, Rossi G, Valente T, Ferrara I, Romano L, Grassi R. Role of helical CT in diagnosis of gallstone ileus and related conditions. AJR Am J Roentgenol. 2005;185(5):1159–65.

    Article  PubMed  Google Scholar 

  28. Lorén I, Lasson A, Nilsson A, Nilsson P, Nirhov N. Gallstone ileus demonstrated by CT. J Comput Assist Tomogr. 1994;18(2):262–5.

    Article  PubMed  Google Scholar 

  29. Swift SE, Spencer JA. Gallstone ileus: CT findings. Clin Radiol. 1998;53(6):451–4.

    Article  CAS  PubMed  Google Scholar 

  30. Reimann AJ, Yeh BM, Breiman RS, Joe BN, Qayyum A, Coakley FV. Atypical cases of gallstone ileus evaluated with multidetector computed tomography. J Comput Assist Tomogr. 2004;28(4):523–7.

    Article  PubMed  Google Scholar 

  31. Delabrousse E, Bartholomot B, Sohm O, Wallerand H, Kastler B. Gallstone ileus: CT findings. Eur Radiol. 2000;10(6):938–40.

    Article  CAS  PubMed  Google Scholar 

  32. Rodríguez-Sanjuán JC, Casado F, Fernández MJ, Morales DJ, Naranjo A. Cholecystectomy and fistula closure versus enterolithotomy alone in gallstone ileus. Br J Surg. 1997;84(5):634–7.

    Article  PubMed  Google Scholar 

  33. Berliner SD, Burson LC. One-stage repair for cholecyst-duodenal fistula and gallstone ileus. Arch Surg. 1965;90:313–6.

    Article  CAS  PubMed  Google Scholar 

  34. Warshaw AL, Bartlett MK. Choice of operation for gallstone intestinal obstruction. Ann Surg. 1966;164(6):1051–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Kasahara Y, Umemura H, Shiraha S, Kuyama T, Sakata K, Kubota H. Gallstone ileus. Review of 112 patients in the Japanese literature. Am J Surg. 1980;140(3):437–40.

    Article  CAS  PubMed  Google Scholar 

  36. Muthukumarasamy G, Venkata SP, Shaikh IA, Somani BK, Ravindran R. Gallstone ileus: surgical strategies and clinical outcome. J Dig Dis. 2008;9(3):156–61.

    Article  PubMed  Google Scholar 

  37. Tan YM, Wong WK, Ooi LLPJ. A comparison of two surgical strategies for the emergency treatment of gallstone ileus. Singap Med J. 2004;45(2):69–72.

    CAS  Google Scholar 

  38. Haq AU, Morris AH, Daintith H. Recurrent gall-stone ileus. Br J Radiol. 1981;54(647):1000–1.

    Article  CAS  PubMed  Google Scholar 

  39. Levin B, Shapiro RA. Recurrent enteric gallstone obstruction. Gastrointest Radiol. 1980;5(2):151–3.

    Article  CAS  PubMed  Google Scholar 

  40. Doogue MP, Choong CK, Frizelle FA. Recurrent gallstone ileus: underestimated. Aust N Z J Surg. 1998;68(11):755–6.

    Article  CAS  PubMed  Google Scholar 

  41. Mir SA, Hussain Z, Davey CA, Miller GV, Chintapatla S. Management and outcome of recurrent gallstone ileus: a systematic review. World J Gastrointest Surg. 2015;7(8):152–9.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Raiford TS. Intestinal obstruction caused by gallstones. Am J Surg. 1962;104:383–94.

    Article  CAS  PubMed  Google Scholar 

  43. Anseline P. Colonic gall-stone ileus. Postgrad Med J. 1981;57(663):62–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Montgomery A. Laparoscope-guided enterolithotomy for gallstone ileus. Surg Laparosc Endosc. 1993;3(4):310–4.

    CAS  PubMed  Google Scholar 

  45. Franklin ME Jr, Dorman JP, Schuessler WW. Laparoscopic treatment of gallstone ileus: a case report and review of the literature. J Laparoendosc Surg. 1994;4(4):265–72.

    Article  PubMed  Google Scholar 

  46. Moberg AC, Montgomery A. Laparoscopically assisted or open enterolithotomy for gallstone ileus. Br J Surg. 2007;94(1):53–7.

    Article  PubMed  Google Scholar 

  47. Allen JW, McCurry T, Rivas H, Cacchione RN. Totally laparoscopic management of gallstone ileus. Surg Endosc. 2003;17(2):352.

    Article  PubMed  Google Scholar 

  48. Owera A, Low J, Ammori BJ. Laparoscopic enterolithotomy for gallstone ileus. Surg Laparosc Endosc Percutan Tech. 2008;18(5):450–2.

    Article  PubMed  Google Scholar 

  49. Sesti J, Okoro C, Parikh M. Laparoscopic enterolithotomy for gallstone ileus. J Am Coll Surg. 2013;217(2):e13–5.

    Article  PubMed  Google Scholar 

  50. Behrens C, Amson B. Laparoscopic management of multiple gallstone ileus. Surg Laparosc Endosc Percutan Tech. 2010;20(2):e64–5.

    Article  PubMed  Google Scholar 

  51. Kim YG, Byeon J-S, Lee SK, Yang D-H, Kim K-J, Ye BD, Myung S-J, Yang S-K, Kim J-H. Gallstone ileus successfully treated with endoscopic fragmentation by using double-balloon endoscopy (with video). Gastrointest Endosc. 2011;74(1):228–30.

    Article  PubMed  Google Scholar 

  52. Muratori R, Cennamo V, Menna M, Cecinato P, Eusebi LH, Mazzella G, Bazzoli F. Colonic gallstone ileus treated with radiologically guided extracorporeal shock wave lithotripsy followed by endoscopic extraction. Endoscopy. 2012;44(Suppl 2 UCTN (S 02)):E88–9.

    PubMed  Google Scholar 

  53. Fujita N, Noda Y, Kobayashi G, Kimura K, Watanabe H, Shirane A, Hayasaka T, Mochizuki F, Yamazaki T. Gallstone ileus treated by electrohydraulic lithotripsy. Gastrointest Endosc. 1992;38(5):617–9.

    Article  CAS  PubMed  Google Scholar 

  54. Sackmann M, Holl J, Haerlin M, Sauerbruch T, Hoermann R, Heinkelein J, Paumgartner G. Gallstone ileus successfully treated by shock-wave lithotripsy. Dig Dis Sci. 1991;36(12):1794–5.

    Article  CAS  PubMed  Google Scholar 

  55. Lowe AS, Stephenson S, Kay CL, May J. Duodenal obstruction by gallstones (Bouveret’s syndrome): a review of the literature. Endoscopy. 2005;37(1):82–7.

    Article  CAS  PubMed  Google Scholar 

  56. Bourke MJ, Schneider DM, Haber GB. Electrohydraulic lithotripsy of a gallstone causing gallstone ileus. Gastrointest Endosc. 1997;45(6):521–3.

    Article  CAS  PubMed  Google Scholar 

  57. Meyenberger C, Michel C, Metzger U, Koelz HR. Gallstone ileus treated by extracorporeal shockwave lithotripsy. Gastrointest Endosc. 1996;43(5):508–11.

    Article  CAS  PubMed  Google Scholar 

  58. Oakland DJ, Denn PG. Endoscopic diagnosis of gallstone ileus of the duodenum. Dig Dis Sci. 1986;31(1):98–9.

    Article  CAS  PubMed  Google Scholar 

  59. Zielinski MD, Ferreira LE, Baron TH. Successful endoscopic treatment of colonic gallstone ileus using electrohydraulic lithotripsy. World J Gastroenterol. 2010;16(12):1533–6.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Doko M, Zovak M, Kopljar M, Glavan E, Ljubicic N, Hochstädter H. Comparison of surgical treatments of gallstone ileus: preliminary report. World J Surg. 2003;27(4):400–4.

    Article  PubMed  Google Scholar 

  61. Rodríguez Hermosa JI, Codina Cazador A, Gironès Vilà J, Roig García J, Figa Francesch M, Acero Fernández D. Gallstone ileus: results of analysis of a series of 40 patients. Gastroenterol Hepatol. 2001;24(10):489–94.

    Article  PubMed  Google Scholar 

  62. Martinez Ramos D, Daroca Jose JM, Escrig Sos J, Paiva Coronel G, Alcalde Sanchez M, Salvador Sanchis JL. Gallstone ileus: management options and results on a series of 40 patients. Rev Esp Enferm Dig. 2009;101(2):117–20. 121-114.

    Article  CAS  PubMed  Google Scholar 

  63. Corvera CU, Reza JA. Chapter 42: Biliary fistulae and strictures A2. In: Jarnagin WR, editor. Blumgart’s surgery of the liver, biliary tract and pancreas, 2-volume set. 6th ed. Philadelphia; 2017. p. 675–713.e679.

    Google Scholar 

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Authors and Affiliations

  1. Division of Trauma/Acute Care Surgery, Medical College of Wisconsin-Froedtert Trauma Center, Milwaukee, WI, USA

    Chris Dodgion & Marc de Moya

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  1. Chris Dodgion
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  2. Marc de Moya
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Correspondence to Chris Dodgion .

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Editors and Affiliations

  1. Dell Medical School, University of Texas at Austin, Austin, TX, USA

    Carlos V. R. Brown

  2. Trauma and Surgical Critical Care, University of Southern California, Los Angeles, CA, USA

    Kenji Inaba

  3. Madigan Army Medical Center, Tacoma, WA, USA

    Matthew J. Martin

  4. Brigham and Womens’s Hospital, Harvard Medical School, Boston, MA, USA

    Ali Salim

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Dodgion, C., de Moya, M. (2019). Gallstone Ileus. In: Brown, C., Inaba, K., Martin, M., Salim, A. (eds) Emergency General Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-96286-3_13

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  • DOI: https://doi.org/10.1007/978-3-319-96286-3_13

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