Successful gallstone ileus treatment by endoscopy

• Published in: Revista española de enfermedades digestivas Vol. 114; no. 12; pp. 754 - 755
• Main Authors: Guerro Moya, Andrea, Couto Wörner, Ignacio, Alonso Aguirre, Pedro Antonio
• Format: Journal Article
• Language: English
• Published: Spain 01-12-2022
• Subjects: Aged; Colonoscopy - adverse effects; Female; Gallstones - complications; Humans; Ileus - etiology; Intestinal Obstruction - etiology; Sigmoid Diseases - diagnosis
• ISSN: 1130-0108
• DOI: 10.17235/reed.2022.8898/2022

We present the case of a 73-year-old woman who was admitted to hospital with a 6-day history of complete constipation, abdominal pain and vomiting. An abdominal CT scan is performed that shows a large colonic dilatation. In the sigmoid colon identifying a 43x20mm gallstone impaction and a solution of continuity between the gallbladder and the hepatic flexure with pneumobilia associated. Because the obstruction is located at the sigmoid colon, it was decided to perform an urgent colonoscopy. During the endoscopy, the gallstone was observed, which was successfully extracted using a Roth Net. The surrounding mucosa showed signs of mucosal damage and an extensive decubitus ulcer. After endoscopy, the patient presented resolution of the obstructive condition. During her admission, surgery was performed to resection the cholecystocolic fistula, cholecystectomy, and primary closure of the colon. However, the patient presented a torpid evolution with ascending colon perforation and necrotizing fasciitis in the surgical wound, finally dying of abdominal septic shock.