+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Gallstone ileus without bilioenteric fistula years after bypass surgery for Crohn's disease. Case report and clues to etiology of a neglected cause of obstruction

Gallstone ileus without bilioenteric fistula years after bypass surgery for Crohn's disease. Case report and clues to etiology of a neglected cause of obstruction

International Journal of Surgery Case Reports 9: 134-138

Gallstone ileus is a very rare cause of bowel obstruction. Patients suffering from Crohn's disease are at increased risk of developing gallstone disease, especially when terminal ileum is involved. Gallstone ileus can occur, but etiology remains controversial. We report on a case of such a rare condition, illustrating etiology and treatments. A patient with long-standing Crohn's disease, who had undergone ileotransverse bypass for ileocaecal involvement 40 years before, presented with cramp-like abdominal pain. Imaging was consistent with a gallstone ileus with no evidence of bilioenteric fistulae. At surgery, we found gallstones stuck at the site of ileotransverse anastomosis. No bilioenteric fistulae were found. Due to disease progression, many enteric fistulae were found, requiring a massive bowel resection. The diverted segment may have been responsible of gallstone formation, and etiology is discussed. Recovery after surgery was uneventful, but the patient required continued nutritional support. Physicians dealing with Crohn's disease patients with bypassed segments should keep in mind, the increased risk of gallstone formation, in order to not overlook gallstone ileus. Early suspect and diagnosis may allow for less aggressive approaches. A diverted segment should always be removed, and long-term follow-up encouraged.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 057917408

Download citation: RISBibTeXText

PMID: 25770438

DOI: 10.1016/j.ijscr.2015.03.004

Related references

Gallstone ileus and Crohn's disease without biliary-enteric fistula: report of a unique case. Mount Sinai Journal of Medicine, New York 67(2): 159-162, 2000

Gallstone ileus in a patient with Crohn's disease: a case report. Acta Chirurgica Belgica 112(5): 390-392, 2012

Development of a duodenal gallstone ileus with gastric outlet obstruction (Bouveret syndrome) four months after successful treatment of symptomatic gallstone disease with cholecystitis and cholangitis: a case report. Journal of Medical Case Reports 4: 376, 2010

Gallstone ileus an unusual reason for right iliac fossa pain in Crohn's disease: a case report. Cases Journal 2: 9285, 2010

Gallstone ileus and cholecystoduodenal fistula. Case report. Cirugia Y Cirujanos 74(3): 199-203, 2006

Gallstone ileus due to cholecysto-gastric fistula: A case report. Nichidai Igaku Zasshi 54(2): 132-135, 1995

Gallstone ileus in patient with Crohn's disease: report of a clinical observation. Surgical Endoscopy 20(4): 703-704, 2006

Gallstone ileus: a rare cause of colon obstruction. Report of a case. Chirurgia Italiana 60(4): 573-576, 2008

Cholecysto-duodeno-colic fistula with gallstone ileus: report of a case. Diseases of the Colon and Rectum 18(8): 702-705, 1975

Cholecystoduodenal fistula with subsequent gallstone ileus: case report of an unusual course. Zentralblatt für Chirurgie 121(5): 408-411, 1996

Uncommon cause of small bowel obstruction - gallstone ileus: a case report. Cases Journal 2: 9321, 2010

Gallstone ileus of the sigmoid colon caused by cholecystocolonic fistula: A case report. Annals of Medicine and Surgery 31: 25-28, 2018

Gallstone ileus: a rare cause of intestinal obstruction -- case report and literature review. Chirurgia 108(5): 741-744, 2014

Gallstone ileus presenting as gastric outlet obstruction (Bouveret's syndrome): a case report. Acta Chirurgica Belgica 106(4): 438-440, 2006

Complications of gallstone disease: Mirizzi syndrome, cholecystocholedochal fistula, and gallstone ileus. American Journal of Gastroenterology 97(2): 249-254, February, 2002