Gallstone ileus
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:
Overview
Gallstone ileus refers to small bowel obstruction resulting from the impaction of one or more gallstones after they have migrated through a cholecystoenteric fistula. Gallstone ileus is a rare disease and accounts for about 1−3% of mechanic ileus of the small bowel, but for 25% of all small bowel obstructions in patients older than 65 years.
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Gallstone ileus from Other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications, and Prognosis
Natural History
Complications
Prognosis
Diagnosis
Diagnostic Criteria
History and Symptoms
Physical Examination
Laboratory Findings
Imaging Findings
CT
CT images demonstrate a gallstone ileus
Other Diagnostic Studies
Treatment
Medical Therapy
Treating the obstruction, along with cholecystectomy and fistula division, with or without common bile duct exploration in a single stage is the preferred surgical approach for gallstone ileus. Treating the obstruction with enterolithotomy alone is the preferred approach for patients who are poor surgical risks. They are further managed expectantly unless recurrent gallstone ileus or cholecystitis necessitate a definitive biliary procedure as the second stage.