Gallstone Ileus with Associated Perforated Small Bowel Diverticulitis: A Rare Case Study

Introduction

Gallstone ileus is a rare but serious complication of cholelithiasis, often leading to mechanical obstruction in the intestinal tract. This condition is more prevalent among the elderly and those with underlying medical conditions. The following case report highlights an unusual presentation of gallstone ileus associated with perforated small bowel diverticulitis.

Visit https://www.clinmedcasereportsjournal.org/acr for more groundbreaking research in this field.

Case Overview

A 72-year-old female presented with acute left iliac fossa pain, nausea, and vomiting. She had a history of Mirizzi syndrome and several comorbidities, including hypertension and rheumatoid arthritis. A CT scan confirmed a cholecystenteric fistula, pneumobilia, and a small bowel obstruction with an ectopic gallstone—a classic presentation of Rigler’s triad.

Key Findings

• CT Scan Diagnosis: Identified gallstone impaction and proximal small bowel diverticulitis.
• Surgical Intervention: The patient underwent laparotomy, gallstone removal, and small bowel resection.
• Postoperative Recovery: Uneventful recovery with successful follow-up at six months.

Importance of Early Diagnosis

Early diagnosis through contrast-enhanced CT is crucial, given that gallstone ileus symptoms are often non-specific. According to the American College of Radiology (ACR), high-resolution imaging plays a vital role in detecting and managing complex abdominal pathologies like gallstone ileus.

Management Strategies

• Stone Extraction: Immediate removal of the obstructing gallstone.
• Fistula Closure: A debated approach—single-stage vs. two-stage surgery.
• Elective Cholecystectomy: May be performed later to prevent recurrence.

Read the Full Study

For an in-depth analysis of this case, read the full study at https://doi.org/10.29328/journal.acr.1001050.

Related Research

Explore more case reports and research on gastrointestinal obstructions and surgical interventions in our archives at https://www.clinmedcasereportsjournal.org/acr.

Conclusion

Gallstone ileus is a rare but critical condition requiring prompt imaging and surgical intervention. This case highlights the importance of considering perforated small bowel diverticulitis as a potential complication in patients presenting with acute abdominal symptoms.

Engage With Us

Explore more studies at https://www.clinmedcasereportsjournal.org/acr and share your insights in the comments below!

Disclaimer: This content is generated using AI assistance and should be reviewed for accuracy and compliance before considering this article and its contents as a reference. Any mishaps or grievances raised due to the reuse of this material will not be handled by the author of this article.

You may provide us with feedback in the comments section.