Gallstone ileus

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Gallstone ileus is a rare form of small bowel obstruction caused by an impaction of a gallstone within the lumen of the small intestine. Such a gallstone is hypothesized to enter the gut lumen via cholecysto-enteric fistula. Large stones, >2.5 cm in diameter, are thought to predispose to fistula formation by gradual erosion through the gallbladder fundus.[1] Most commonly, obstruction occurs at the distal ileum (i.e. ileocecal valve), but can occur at almost any other location in the GI tract.[2]

The name "gallstone ileus" is a misnomer because an ileus is, by definition, a non-mechanical small bowel motility failure.'

Diagnosis[edit]

Diagnosis of gallstone ileus requires radiographic studies. Classic findings of pneumobilia, small bowel obstruction, and radiolucent gallstone on abdominal plain films is known as Rigler's Triad.[3]

Treatment[edit]

Since gallstone ileus constitutes a form of mechanical small bowel obstruction, it can be a surgical emergency and requires laparoscopic removal or propulsion of impacted stone.[1]

Eponym[edit]

This condition is also known by the eponym Barnard's Syndrome

References[edit]

  1. ^ a b Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J. Chapter 311. Diseases of the Gallbladder and Bile Ducts. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J, eds. Harrison's Principles of Internal Medicine. 18th ed. New York: McGraw-Hill; 2012. http://www.accessmedicine.com/content.aspx?aID=9135488. Accessed December 17, 2013.
  2. ^ Gaillard F. Radiopaedia.org - Gallstone Ileus. http://radiopaedia.org/cases/gallstone-ileus. Accessed December 17, 2013
  3. ^ Jones J, Gaillard F. Radiopaedia.org - Rigler's Triad. http://radiopaedia.org/articles/riglers-triad. Accessed December 17, 2013