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首页> 美国卫生研究院文献>International Journal of Surgery Case Reports >A chip off the old block—A case report of gallstone ileus in which identification of a facetted stone was essential in preventing re-laparotomy
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A chip off the old block—A case report of gallstone ileus in which identification of a facetted stone was essential in preventing re-laparotomy

机译：脱离旧块的胆结石—胆石性肠梗阻的病例报告在该病例中鉴定多面结石对预防再次开腹手术至关重要

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摘要

Gallstone ileus is a rare presentation, accounting for 0.1% of cases of mechanical small bowel obstruction. Patients are often elderly with significant comorbidity. Treatment is based upon laparotomy and enterolithotomy. We present the case of a 75 year old lady admitted as an emergency with a 4 day history of small bowel obstruction. She was found on CT scan to have an impacted gallstone in the distal ileum. At operation, her impacted stone was removed through a proximal enterostomy. The stone however was found to have a squared off edge, raising the suspicion of a second fragment within the proximal small bowel lumen. Failure to retrieve this could have led to re-obstruction requiring a return to theatre and repeat laparotomy in an elderly patient with the associated morbidity.
机译：胆石性肠梗阻是一种罕见的表现，占机械性小肠梗阻病例的0.1％。患者通常是患有严重合并症的老年人。治疗基于开腹手术和肠石切开术。我们呈现的是一名75岁的老妇人，因其肠梗阻有4天的病史而被录入紧急情况。在CT扫描中发现她的回肠末端胆囊结石受累。手术时，她的结石通过近端肠造口术被切除。然而，发现该结石的边缘呈方形，增加了人们怀疑在近端小肠管腔内有第二个碎片的可能性。未能恢复到这种情况可能会导致再次梗阻，需要在有相关疾病的老年患者中重返剧院并再次进行剖腹手术。

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