[Clinical and imaging aspects of gallstone ileus. Experiences with 108 individual observations]. / Klinische und bildgebende Aspekte des Gallensteinileus. Erfahrungen mit 108 Einzelbeobachtungen.

Cases of gallstone ileus (108) were analyzed retrospectively over 30 years. Even today, when laparoscopic cholecystectomy is done, the incidence of this rare disease remains the same. History, clinical and X-ray findings are non-specific. Aerobilia was seen in 17% of the patients. Since 1992 sonography has provided an exact diagnosis in 10 of 15 cases. In the triad of known gallstone, non-specific epigastric pain with assumed small intestinal obstruction, and impossible detection of a stone in the gallbladder, there is strong suspicion of a gallstone ileus. The evidence is given if the gallstone is seen in the bowels. Intraoperatively more than one stone was found in the intestines in 20%, and cholecystoduodenal fistulas were encountered in 83%. Other fistulas are rare. There has been no significant change in mortality for 30 years.