胆石イレウスの1例

Abstract

Gallstone ileus is a rare complication of cholecystolithiasis. We report a case of gallstone ileus diagnosed preoperatively by abdominal computed tomography (CT). A 57-year-old female was admitted to our hospital due to epigastric pain and vomiting. She had a history of cholecystolithiasis. Abdominal plain X-ray showed niveau and abdominal CT showed the presence of calcification round in shape (20mm in diameter) in the small intestine and cholecystoduodenal fistula. Laparotomy was performed under a diagnosis of gallstone ileus with cholecystoduodenal fistula. At exploration, a stone packed in the ileum 50cm oral from the ileum end was found and a wall-thickened gallbladder was found firmly adherent at the duodenum. We removed the impacted stone from the intestine and performed cholecystectomy and placed an omental patching after trimming the wall of the duodenum to close the cholecystoduodenal fistula. The CT findings allowed a definitive diagnosis preoperatively in this case.