Emergency Cases Northwest Group

057 A Galling Diagnosis

Situation

A man had vomiting: it was gall stone ileus.

Background

A 91 year old man presented with vomiting+++, some abdominal pain and distension. He had known gallstones, previous cholecystitis. His abdominal X-ray looked similar to this:

https://casesjournal.biomedcentral.com/articles/10.1186/1757-1626-2-9142

His CT scan showed gallstone ileus with a fistula formed between the gallbladder and GI tract.

Assessment

He had small bowel obstruction which was caused by a large gallstone in the lumen of the GI tract. [The x-ray shows the gallstone in the small bowel and not in the gallbladder]

The gallbladder infection and inflammation caused a fistula or passage to form between the gallbladder and small bowel. The large gall stone then passed through this and entered the small bowel, subsequently getting lodged in the bowel and causing obstruction.

Recommendation

Be aware that gallstones can cause this unusual complication, especially in elderly patients.

And be aware that it’s a serious condition that usually needs surgery.



PLEASE DO NOT INCLUDE ANY PATIENT IDENTIFIABLE DATA OR GEO-LOCATION DATA IN THE SUBMISSION OR IN ANY ATTACHED IMAGES

Emergency Cases Northwest Group