Perforated Closed-Loop Obstruction Secondary to Gallstone Ileus of the Transverse Colon: A Rare Entity
Introduction. Gallstone ileus (GSI) of the colon is an extremely rare entity with potentially serious complications including perforation. Case Presentation. An 88-year-old man presented to the emergency department with abdominal pain and distension. Clinical exam revealed signs of peritonism. Compu...
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| Format: | Article |
| Language: | English |
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Wiley
2015-01-01
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| Series: | Case Reports in Surgery |
| Online Access: | http://dx.doi.org/10.1155/2015/691713 |
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| author | S. P. Carr F. T. MacNamara K. M. Muhammed E. Boyle S. M. McHugh P. Naughton A. Leahy |
| author_facet | S. P. Carr F. T. MacNamara K. M. Muhammed E. Boyle S. M. McHugh P. Naughton A. Leahy |
| author_sort | S. P. Carr |
| collection | DOAJ |
| description | Introduction. Gallstone ileus (GSI) of the colon is an extremely rare entity with potentially serious complications including perforation. Case Presentation. An 88-year-old man presented to the emergency department with abdominal pain and distension. Clinical exam revealed signs of peritonism. Computed tomography (CT) revealed GSI of the transverse colon with a closed-loop large bowel obstruction (LBO) and caecal perforation. The patient underwent emergency laparotomy. A right hemicolectomy was performed, the gallstone was removed, and a primary bowel anastomosis was undertaken. A Foley catheter was sutured into the residual gallbladder bed to create a controlled biliary fistula. The patient recovered well postoperatively with no complications. He was discharged home with the Foley catheter in situ. Discussion. Gallstone ileus is a difficult diagnosis both clinically and radiologically with only 50% of cases being diagnosed preoperatively. Most commonly it is associated with impaction at the ileocaecal valve and small bowel obstruction. Gallstone ileus should also be considered as a rare but potential cause of LBO. This is the first reported case of caecal perforation secondary to gallstone ileus of the transverse colon. Successful operative management consisted of a one-stage procedure with right hemicolectomy and formation of a controlled biliary fistula. |
| format | Article |
| id | doaj-art-e0007b5363ef448cbeb760fc2e9a639c |
| institution | Kabale University |
| issn | 2090-6900 2090-6919 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Surgery |
| spelling | doaj-art-e0007b5363ef448cbeb760fc2e9a639c2025-02-03T05:45:17ZengWileyCase Reports in Surgery2090-69002090-69192015-01-01201510.1155/2015/691713691713Perforated Closed-Loop Obstruction Secondary to Gallstone Ileus of the Transverse Colon: A Rare EntityS. P. Carr0F. T. MacNamara1K. M. Muhammed2E. Boyle3S. M. McHugh4P. Naughton5A. Leahy6Royal College of Surgeons in Ireland, Dublin 2, IrelandRoyal College of Surgeons in Ireland, Dublin 2, IrelandDepartment of Surgery, Beaumont Hospital, Dublin 17, IrelandRoyal College of Surgeons in Ireland, Dublin 2, IrelandRoyal College of Surgeons in Ireland, Dublin 2, IrelandRoyal College of Surgeons in Ireland, Dublin 2, IrelandRoyal College of Surgeons in Ireland, Dublin 2, IrelandIntroduction. Gallstone ileus (GSI) of the colon is an extremely rare entity with potentially serious complications including perforation. Case Presentation. An 88-year-old man presented to the emergency department with abdominal pain and distension. Clinical exam revealed signs of peritonism. Computed tomography (CT) revealed GSI of the transverse colon with a closed-loop large bowel obstruction (LBO) and caecal perforation. The patient underwent emergency laparotomy. A right hemicolectomy was performed, the gallstone was removed, and a primary bowel anastomosis was undertaken. A Foley catheter was sutured into the residual gallbladder bed to create a controlled biliary fistula. The patient recovered well postoperatively with no complications. He was discharged home with the Foley catheter in situ. Discussion. Gallstone ileus is a difficult diagnosis both clinically and radiologically with only 50% of cases being diagnosed preoperatively. Most commonly it is associated with impaction at the ileocaecal valve and small bowel obstruction. Gallstone ileus should also be considered as a rare but potential cause of LBO. This is the first reported case of caecal perforation secondary to gallstone ileus of the transverse colon. Successful operative management consisted of a one-stage procedure with right hemicolectomy and formation of a controlled biliary fistula.http://dx.doi.org/10.1155/2015/691713 |
| spellingShingle | S. P. Carr F. T. MacNamara K. M. Muhammed E. Boyle S. M. McHugh P. Naughton A. Leahy Perforated Closed-Loop Obstruction Secondary to Gallstone Ileus of the Transverse Colon: A Rare Entity Case Reports in Surgery |
| title | Perforated Closed-Loop Obstruction Secondary to Gallstone Ileus of the Transverse Colon: A Rare Entity |
| title_full | Perforated Closed-Loop Obstruction Secondary to Gallstone Ileus of the Transverse Colon: A Rare Entity |
| title_fullStr | Perforated Closed-Loop Obstruction Secondary to Gallstone Ileus of the Transverse Colon: A Rare Entity |
| title_full_unstemmed | Perforated Closed-Loop Obstruction Secondary to Gallstone Ileus of the Transverse Colon: A Rare Entity |
| title_short | Perforated Closed-Loop Obstruction Secondary to Gallstone Ileus of the Transverse Colon: A Rare Entity |
| title_sort | perforated closed loop obstruction secondary to gallstone ileus of the transverse colon a rare entity |
| url | http://dx.doi.org/10.1155/2015/691713 |
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