Anesthesia & Clinical Research
Open Access

Gallstone ileus: A rare complication of a common disease

Joint Event on 2^nd World Congress on Surgeons & 12^th International Conference on Anesthesiology and Critical Care

November 11-12, 2019 | Istanbul, Turkey

Mohd Abdul Hadi Mohd Anuar, April Camilla Roslani, Nora Abdul Aziz and Michael Wong Pak Kai

University Malaya Medical Centre, Malaysia

Posters & Accepted Abstracts: J Anesth Clin Res

Abstract :

Gallstone disease is a common entity worldwide, differs in types according to the dietary, hereditary factors and geographical predispositions. Common complications are ascending cholangitis, pancreatitis, symptomatic cholelithiasis and obstructive jaundice. However, acute mechanical bowel obstruction secondary to impacted enterolithiasis as a result of cholecysto-enteric fistula is relatively rare. Diagnosis of Gallstone Ileus (GI) is based on high clinical suspicion in acute presentation of bowel obstruction with recent biliary symptoms, presence of pneumobilia on plain abdominal X-ray with dilated loops of bowel and detection of ectopic gallstones. Computed tomography is the radiological modality of choice to diagnose GI, to locate the ectopic gallstones, to identify cholecysto-enteric fistula and to detect intra-abdominal collection, presence of pneumobilia or pneumoperitoneum. Initial management is similar to those patients whom presented with acute mechanical bowel obstruction. Operative options, including two-stage surgery (emergency enterolithotomy alone followed by elective cholecystectomy) vs. single-stage surgery (enterolithotomy, fistula closure and cholecystectomy) remain controversial. We present a case of GI in an elderly lady with back ground history of cholelithiasis whom presented with acute onset of intestinal obstruction. She successfully underwent an emergency exploratory laparotomy and enterolithotomy during the acute presentation and subsequently scheduled for elective laparoscopic cholecystectomy two months after the primary surgery.

Biography :

Mohd Abdul Hadi Mohd Anuar is currently pursuing Masters of General Surgery in University of Malaya, Kuala Lumpur. He has completed MBBS degree in University of Malaya in the year 2011 and has been working as Surgical Trainee for 6 years.