ABSTRACT
Ten patients with gallstone ileus were studied to evaluate diagnostic and therapeutic procedures. The preoperative diagnosis was correct in four patients. All patients underwent laparotomy. In five patients, stones were removed by enterotomy and in three patients the obstruction was relieved by manual propulsion of the stones. One-stage small-bowel resection, cholecystectomy, and biliary enteric fistula repair were performed in two patients. Four patients had uneventful recovery. One episode of recurrent gallstone ileus was encountered. Three patients died of septic complications. It is concluded from the study and from a review of the literature that treatment should be aimed at relieving the obstruction, without performing additional surgical procedures, such as cholecystectomy and fistula repair. Secondary biliary surgery is to be performed only in patients with recurrent biliary disease.
Subject(s)
Cholelithiasis/complications , Intestinal Obstruction/etiology , Aged , Aged, 80 and over , Colonic Diseases/etiology , Colonic Diseases/therapy , Humans , Ileal Diseases/etiology , Ileal Diseases/therapy , Intestinal Obstruction/therapy , Jejunal Diseases/etiology , Jejunal Diseases/therapy , Male , Middle AgedABSTRACT
A case is reported of a sigmoidoappendiceal fistula due to diverticulitis of the sigmoid colon. Only one case has been reported previously.
