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Ann Geriatr Med Res > Volume 18(4); 2014 > Article
Journal of the Korean Geriatrics Society 2014;18(4):246-250.
DOI: https://doi.org/10.4235/jkgs.2014.18.4.246    Published online December 31, 2014.
Gallstone Ileus in 83-Year-Old Woman
Song Hee Oh, Jun Ho Jo, Il Soo Kim, Woo Young Kim, Kun Woo Park, Min Woong Jung, Jong Ik Park, Se Ryeong Park
Departments of 1Internal Medicine and 2Sugery, Busan Veterans Hospital, Busan, Korea
83세 여자 환자에서 발생한 담석 장폐쇄 1예
부산보훈병원 내과1, 외과2
Gallstone ileus is a rare complication of the biliary stone, occurring in 0.3-0.5% of patients with cholelithiasis. The mortality rate is high at 12-27% and early diagnosis and prompt management can improve its prognosis. An 83-year-old woman was admitted to the hospital with abdominal pain. The patient previously had a hysterectomy and had received radiation therapy for uterine cancer. Plain abdominal x-ray showed typical findings of small bowel ileus with step ladder patterns. Computed tomography (CT) scan revealed biliary-enteric fistula with a 3-cm-sized gallstone in the jejunal loop. Surgical treatment was planned but due to the patient's wish, conservative treatment was provided for 10 days. In the follow-up CT scan, the stone had moved to the distal ileum but intestinal perforation was suspected. Ileocecectomy and adhesiolysis were performed and the patient recovered fully. Here we report a case of gallstone ileus that was treated by surgical removal after 10 days of conservative treatment.
Key Words: Gallstones, Ileus, Intestinal perforation
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