Gallstone ileus-induced intestinal obstruction in a 38-year-old patient with a history of three pregnancies and cesarean section: a case report
DOI:
https://doi.org/10.24265/horizmed.2024.v24n1.09Keywords:
Ileal Diseases, Intestinal Obstruction, Cesarean Section, Ileum, Bile Duct DiseasesAbstract
Gallstone ileus-induced intestinal obstruction is a rare but significant condition that occurs when a gallstone becomes lodged in the gastrointestinal tract. Major risk factors for gallstone ileus-induced intestinal obstruction include older age, female sex, diabetes, history of gallbladder disease such as gallstones, as well as previous gallbladder-related surgical procedures such as cholecystectomy. Pregnancy is also a known risk factor for gallstone disease. We present the case of a 38-year-old patient with a history of three cesarean sections and no apparent comorbidities. Prior to her visit to the emergency department, the patient experienced moderate colicky abdominal pain in the lower abdomen for two days. The physical examination revealed diffuse abdominal tenderness, predominantly in the right iliac fossa, along with signs of irritation of the peritoneum. Laboratory tests showed a leukocyte count of 11,490 cells/µl and neutrophilia of 85.6 %. Following an exploratory laparotomy, the suspected diagnosis of gallstone ileus was confirmed. An enterolithotomy was performed, and the patient experienced good post-surgical progress. In conclusion, it is important to consider gallstone ileus-induced intestinal obstruction among patients with relevant symptoms and medical history. This case report highlights the importance of considering gallstone ileus-induced intestinal obstruction among patients with gastrointestinal symptoms and a history of pregnancy. Early diagnosis and intervention are crucial to prevent serious complications.
Downloads
References
Turner AR, Sharma B, Mukherjee S. Gallstone Ileus. En: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [citado el 2 de noviembre de 2023]. Disponible en: http://www.ncbi.nlm.nih.gov/books/NBK430834/
Ploneda-Valencia CF, Gallo-Morales M, Rinchon C, Navarro-Muniz E, Bautista-Lopez CA, de la Cerda-Trujillo LF, et al. Gallstone ileus: An overview of the literature. Rev Gastroenterol Mex. 2017;82(3):248-54. 3. Nuno-Guzman CM, Marin-Contreras ME, Figueroa-Sanchez M, Corona JL. Gallstone ileus, clinical presentation, diagnostic and treatment approach. World J Gastrointest Surg. 2016;8(1):65-76. 4. Chuah JS, Tan JH, Khairudin KB, Ling LLL, Mat T. Case series of gallstone ileus with one- or two-stage surgery. Ann Hepatobiliary Pancreat Surg. 2022;26(2):199-203. 5. Kosco E, Keener M, Waack A, Ranabothu AR, Vattipally V. Radiological diagnosis and surgical treatment of gallstone ileus. Cureus. 2023;15(5):e38481. 6. Chang L, Chang M, Chang HM, Chang AI, Chang F. Clinical and radiological diagnosis of gallstone ileus: a mini review. Emerg Radiol. 2018;25(2):189-96. 7. Portincasa P, Di Ciaula A, de Bari O, Garruti G, Palmieri VO, Wang DQ. Management of gallstones and its related complications. Expert Rev Gastroenterol Hepatol. 2016;10(1):93-112. 8. Sartelli M, Chichom-Mefire A, Labricciosa FM, Hardcastle T, AbuZidan FM, Adesunkanmi AK, et al. Erratum to: The management of intra-abdominal infections from a global perspective: 2017 WSES guidelines for management of intra-abdominal infections. World J Emerg Surg. 2017;12:36. 9. Ayantunde AA, Agrawal A. Gallstone ileus: diagnosis and management. World J Surg. 2007;31(6):1292-7. 10. Inukai K. Gallstone ileus: a review. BMJ Open Gastroenterol. 2019;6(1):e000344. 11. Chilimuri S, Gaduputi V, Tariq H, Nayudu S, Vakde T, Glandt M, et al. Symptomatic gallstones in the young: changing trends of the gallstone disease-related hospitalization in the State of New York: 1996 - 2010. J Clin Med Res. 2017;9(2):117-23. 12. Vasilescu AM, Tarcoveanu E, Bradea C, Lupascu C, Stagniti F. Gallstone Ileus. What therapeutic options are there? Ann Ital Chir. 2022;92:300-6. 13. Vera-Mansilla C, Sanchez-Gollarte A, Matias B, Mendoza-Moreno F, Diez-Alonso M, Garcia-Moreno Nisa F. Surgical Treatment of Gallstone Ileus: Less Is More. Visc Med. 2022;38(1):72-7. 14. Salazar-Jimenez MI, Alvarado-Duran J, Fermin-Contreras MR, RiveroYanez F, Lupian-Angulo AI, Herrera-Gonzalez A. [Gallstone ileus, surgical management review]. Cir Cir. 2018;86(2):182-6. 15. Dunphy L, Al-Shoek I. Gallstone ileus managed with enterolithotomy. BMJ Case Rep. 2019;12(10):e231581. 16. Requena-Lopez AA, Mata-Samperio BK, Solis-Almanza F, CasillasVargas R, Cuadra-Reyes LA. Comparison between surgical techniques in gallstone ileus and outcomes. Cir Cir. 2020;88(3):292-6.
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Horizonte Médico (Lima)
This work is licensed under a Creative Commons Attribution 4.0 International License.
Horizonte Médico (Lima) (Horiz. Med.) journal’s research outputs are published free of charge and are freely available to download under the open access model, aimed at disseminating works and experiences developed in biomedical and public health areas, both nationally and internationally, and promoting research in the different fields of human medicine. All manuscripts accepted and published in the journal are distributed free of charge under the terms of a Creative Commons license – Attribution 4.0 International (CC BY 4.0).
