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Gallstone ileus: dilemma in the management

Girish D. Bakhshi, Rajesh G. Chincholkar, Jasmine R. Agarwal, Madhukar R. Gupta, Prachiti S. Gokhe, Amogh R. Nadkarni
  • Girish D. Bakhshi
    Department of General Surgery, Grant Government Medical College & Sir JJ Group of Hospitals, Mumbai, India | gdbakhshi@yahoo.com
  • Rajesh G. Chincholkar
    Department of General Surgery, Grant Government Medical College & Sir JJ Group of Hospitals, Mumbai, India
  • Jasmine R. Agarwal
    Department of General Surgery, Grant Government Medical College & Sir JJ Group of Hospitals, Mumbai, India
  • Madhukar R. Gupta
    Department of General Surgery, Grant Government Medical College & Sir JJ Group of Hospitals, Mumbai, India
  • Prachiti S. Gokhe
    Department of General Surgery, Grant Government Medical College & Sir JJ Group of Hospitals, Mumbai, India
  • Amogh R. Nadkarni
    Department of General Surgery, Grant Government Medical College & Sir JJ Group of Hospitals, Mumbai, India

Abstract

Gallstone ileus is a mechanical intestinal obstruction caused due to impaction of a large gallstone within the bowel. The ideal treatment of gallstone ileus remains controversial, with the main dilemma being between a one-stage and a two-stage surgical procedure. A 69-year old male patient presented with gallstone ileus. A one-stage procedure with enterolithotomy and primary closure of duodenal fistula was done. His immediate postoperative recovery was uneventful, but after 3 weeks of surgery, he developed respiratory complications and expired of multi-organ failure. In gallstone ileus, patient presents with symptoms of intestinal obstruction. Enterolithotomy alone remains the most common operative method, but the definitive surgical management is still under research. An intraoperative dilemma between a one-stage or twostage surgery is difficult to resolve in absence of clear guidelines. Hence, more studies are required to come to a consensus in deciding its definitive management.

Keywords

Gallstone; obstruction; ileus, surgery.

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Submitted: 2017-05-03 16:22:15
Published: 2017-08-01 09:53:57
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Copyright (c) 2017 Girish D. Bakhshi, Rajesh G. Chincholkar, Jasmine R. Agarwal, Madhukar R. Gupta, Prachiti S. Gokhe, Amogh R. Nadkarni

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