Gallstone ileus: Demographic and clinical criteria supporting preoperative diagnosis
Küçük Resim Yok
Tarih
2001
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Gallstone ileus is an uncommon intestinal obstruction with unexpectedly high mortality. It is not easy to diagnose this uncommon disease preoperatively. The aim of our study is to establish some simple criteria supporting the suspicion of gallstone ileus in patients with small intestine obstruction. We retrospectively analysed hospital records of 8 patients with gallstone ileus and 1230 cases of mechanical intestinal obstruction, excluding incarcerated external hernias. Gallstones were the cause of occlusion in 0.9% (8/886) of patients with small bowel obstruction. All our 8 patients were women with an average age of 74 years. Gallstone ileus was diagnosed in 18% of elderly (+70 years) women with small intestine obstruction. This rate raised to 36% in this group of elderly women if previous abdominal operations that would produce adhesion were excluded. Previous ultrasonographic examinations had demonstrated gallstones in 5 (62%) patients. Only one patient (12.5%) was diagnosed preoperatively with plain X ray film demonstrating gas in the biliary tract. The obstruction was treated with enterolithotomy. Cholecystectomy was performed in two (25%) patients. The mortality was 25% in early postoperative period. Advanced age, female sex, and positive patient's history of known gallstone in the gallbladder have appeared as strong criteria. Gallstone ileus is a common cause of intestinal obstruction in elderly women with no previous abdominal operations and without incarcerated external hernia. Pneumobilia is more common radiological finding to establish the diagnosis of gallstone ileus in these patients.
Açıklama
Anahtar Kelimeler
Clinical Criteria
Kaynak
Ulusal travma dergisi = Turkish journal of trauma & emergency surgery : TJTES
WoS Q Değeri
Scopus Q Değeri
N/A
Cilt
7
Sayı
1
