J Korean Med Sci.  2009 Dec;24(6):1216-1219. 10.3346/jkms.2009.24.6.1216.

Gallstone Obstructive Ileus 3 Years Post-cholecystectomy to a Patient with an Old Ileoileal Anastomosis

• Papavramidis T
• Potsi S
• Paramythiotis D
• Michalopoulos A
• Papadopoulos V
• Douros V
• Pantoleon
• Foutzila-Kalogera A
• Ekonomou I
• Harlaftis

• KMID: 1783160
• DOI: http://doi.org/10.3346/jkms.2009.24.6.1216

Abstract

The present case is one of gallstone obstructive ileus due to gallstones 3 yr after laparoscopic cholecystectomy. It is interesting because of the sex of the patient, the fact that ileus occurred 3 yr after cholecystectomy and that the localization of the obstruction was an old side-to-side ileoileal anastomosis due to a diverticulectomy following intussusception of Meckels' diverticulum at the age of 3.

Keyword

Gallstones; Ileus

MeSH Terms

Adult
Anastomosis, Surgical/*adverse effects
Child, Preschool
Cholecystectomy, Laparoscopic/*adverse effects
Gallstones/*complications
Humans
Ileum/pathology/*surgery
Ileus/*etiology
Intestinal Obstruction/*etiology
Male
Meckel Diverticulum/surgery

Figure

• 

  Fig. 1 Two calcified opacities were detected in the left iliac fossa at the supine radiograph (RX), (A) which changed location at the erect RX. (B) At profile plain RX of the abdomen these two intraluminal abnormalities appeared in the dilated small bowel of terminal ileum, (C) compatible with gallstones.

• 

  Fig. 2 Gallstones were identified within the dilated bowel as floating hyper-echoic foci producing distal acoustic shadowing reflections, which moved when the patient's position was changed.

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  Fig. 3 CT scans showed multiple air-fluid interfaces the distended small bowel loops and two big ectopic peripheral calcified stones with radiolucent centers in the dilated small bowel.

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  Fig. 4 Side-to-side ileoileic anastomosis. The stone's colour was black and their size was about 3 cm in diameter.

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