A case report of gallstone ileus caused by biliary-intestinal fistula: Multidetector computed tomography features analysis.

Abstract

Introduction and significance: Gallstone ileus is a mechanical intestinal obstruction caused by gallstones or stones from the common bile duct entering the intestinal canal through a biliary-intestinal fistula and becoming impacted. Multidetector computed tomography (MDCT) scanning is the most important auxiliary diagnostic method for this disease.

Case presentation: We report a rare case of gallstone ileus involving an elderly female patient and analyze the characteristics of the MDCT images: atrophic cholecystitis, gallstones, the formation of a local duodenal-gallbladder fistula, pneumatosis in the intrahepatic bile ducts of the left lobe of the liver and some extrahepatic bile ducts, intestinal mechanical obstruction, and the presence of an ectopic stone. A partial small bowel resection was performed and the stone was removed.

Clinical discussion: Gallstone ileus is a rare disease that often occurs in elderly women. It has no specific clinical symptoms and is prone to delayed diagnosis and treatment. MDCT scanning is the most sensitive and accurate diagnostic method for gallstone ileus, once the disease is clearly diagnosed, surgical treatment is recommended as soon as possible.

Conclusion: The aim of this study is to elevate the understanding and treatment of gallstone ileus.