Abstract
Gallstone ileus occurs when the small or large intestine is obstructed by a gallstone and is a rare occurrence in a post-cholecystectomy patient. Non-specific clinical symptoms and inconsistent imaging results often lead to a delay in diagnosis. Complex anatomy, such as a Roux-en-Y biliary-enteric anastomosis, can increase the risk of stone formation and further confound a potential case of gallstone ileus. Here, we present a rare case of gallstone ileus at the anastomosis site of a Roux-en-Y hepaticojejunostomy done 30 years prior for a common bile duct injury during a cholecystectomy. The possibility of negative CT findings, pattern of presentation on imaging as intussusception, and potential pathomechanism of gallstone formation in post-cholecystectomy patients are discussed. Through this case and review of similar cases, we emphasise the need for further study of post-cholecystectomy gallstone ileus and the importance of clinical suspicion during diagnosis.
Reference22 articles.
1. Gallstones;Lammert;Nat Rev Dis Primers,2016
2. Gallstone Ileus: an overview of the literature;Ploneda-Valencia;Rev Gastroenterol Mex,2017
3. An intriguing case of gallstone Ileus after hepaticojejunostomy caused by a‘stone on a suture’;Gachabayov;J Res Med Sci,2016
4. Surgery for Gallstone Ileus
5. Gallstone Ileus: a review of 1001 reported cases;Reisner;Am Surg,1994