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Gallstone Ileus in the Absence of Biliary Fistula

Gallstone Ileus in the Absence of Biliary Fistula Abstract One of the more uncommon causes of acute intestinal obstruction is impaction of a gallstone in the intestinal lumen. Almost without exception, this is the result of a spontaneous internal biliary fistula, occurring most frequently between the gallbladder and the duodenum. A gallstone ileus, in the absence of a previous communication between intestine and biliary tree, is, however, a rare occurrence; only two such cases have been discovered in the literature. The site of formation of the stone in one of these cases was a duodenal diverticulum1 and in the other a blind duodenal stump following subtotal gastrectomy.2 It is the purpose of this report to review briefly the problem of gallstone obstruction of the intestinal tract and to present a third case of acute intestinal obstruction resulting from impaction of a large gallstone in the terminal ileum in the absence of a previous biliary-tract fistula. Incidence In References 1. Dulin, J. W., and Peterson, F. R.: Intestinal Obstruction Due to Gallstones: Report of 10 Cases , Arch. Surg. 38:351, 1939.Crossref 2. Warner, G., and Swan, H.: Gallstone Obstruction of Small Bowel Occurring in the Absence of the Gall Bladder , Surgery 30:865, 1951. 3. McLaughlin, C. W., Jr., and Raines, M.: Obstruction of the Alimentary Tract from Gallstones , Am. J. Surg. 81:424, 1951.Crossref 4. Wakeley, C. P. G., and Willway, F. W.: Intestinal Obstruction by Gallstones , Brit. J. Surg. 23:377, 1935.Crossref 5. Bennett, C.: Obstruction of Small Intestine by Gall Stones: Three Cases Without Mortality , Brit. M. J. 1:565, 1926.Crossref 6. Moore, G. A.: Gall Stone Ileus , Boston M. & S. J. 192:1051, 1925. 7. McQueeney, A. M.: Internal Biliary Fistulae and Intestinal Obstructions Due to Gallstones , Ann. Surg. 110:50, 1939. 8. Wakefield, E. G.; Vickers, P. M., and Walters, W.: Intestinal Obstruction Caused by Gallstones , Surgery 5:670, 1939. 9. Moynihan, B. G. A.: Gall-Stones and Their Surgical Treatment , Ed. 2, Philadelphia, W. B. Saunders and Company, 1905. 10. Wangensteen, O. H.: Intestinal Obstructions: A Physiological and Clinical Consideration with Emphasis on Therapy, Including Description of Operative Procedures , Ed. 2, Springfield, Ill., Charles C Thomas, Publisher, 1942. 11. Turner, G. G.: A Giant Gall-Stone Impacted in the Colon and Causing Acute Obstruction , Brit. J. Surg. 20:26, 1932. 12. Rigler, L. G.; Borman, C. N., and Noble, J. F.: Gallstone Obstruction: Pathogenesis and Roentgen Manifestations , J. A. M. A. 117:1753, 1941. 13. Courvoisier, L. G.: Casuistisch-statistische Beiträge zur Pathologie und Chirurgie der Gallenwege , Leipzig, F. C. W. Vogel, 1890, Vol. 12. 14. Vin Zant, L. E., and Hibbard, J. S.: Recurrent Ileus Due to Gallstones , J. Kansas M. Soc. 50:17, 1949. 15. Maingot, R.: Abdominal Operations , Ed. 3, New York, Appleton-Century-Crofts, Inc., 1955. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives Surgery American Medical Association

Gallstone Ileus in the Absence of Biliary Fistula

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References (18)

Publisher
American Medical Association
Copyright
Copyright © 1958 American Medical Association. All Rights Reserved.
ISSN
0096-6908
DOI
10.1001/archsurg.1958.01280220050010
Publisher site
See Article on Publisher Site

Abstract

Abstract One of the more uncommon causes of acute intestinal obstruction is impaction of a gallstone in the intestinal lumen. Almost without exception, this is the result of a spontaneous internal biliary fistula, occurring most frequently between the gallbladder and the duodenum. A gallstone ileus, in the absence of a previous communication between intestine and biliary tree, is, however, a rare occurrence; only two such cases have been discovered in the literature. The site of formation of the stone in one of these cases was a duodenal diverticulum1 and in the other a blind duodenal stump following subtotal gastrectomy.2 It is the purpose of this report to review briefly the problem of gallstone obstruction of the intestinal tract and to present a third case of acute intestinal obstruction resulting from impaction of a large gallstone in the terminal ileum in the absence of a previous biliary-tract fistula. Incidence In References 1. Dulin, J. W., and Peterson, F. R.: Intestinal Obstruction Due to Gallstones: Report of 10 Cases , Arch. Surg. 38:351, 1939.Crossref 2. Warner, G., and Swan, H.: Gallstone Obstruction of Small Bowel Occurring in the Absence of the Gall Bladder , Surgery 30:865, 1951. 3. McLaughlin, C. W., Jr., and Raines, M.: Obstruction of the Alimentary Tract from Gallstones , Am. J. Surg. 81:424, 1951.Crossref 4. Wakeley, C. P. G., and Willway, F. W.: Intestinal Obstruction by Gallstones , Brit. J. Surg. 23:377, 1935.Crossref 5. Bennett, C.: Obstruction of Small Intestine by Gall Stones: Three Cases Without Mortality , Brit. M. J. 1:565, 1926.Crossref 6. Moore, G. A.: Gall Stone Ileus , Boston M. & S. J. 192:1051, 1925. 7. McQueeney, A. M.: Internal Biliary Fistulae and Intestinal Obstructions Due to Gallstones , Ann. Surg. 110:50, 1939. 8. Wakefield, E. G.; Vickers, P. M., and Walters, W.: Intestinal Obstruction Caused by Gallstones , Surgery 5:670, 1939. 9. Moynihan, B. G. A.: Gall-Stones and Their Surgical Treatment , Ed. 2, Philadelphia, W. B. Saunders and Company, 1905. 10. Wangensteen, O. H.: Intestinal Obstructions: A Physiological and Clinical Consideration with Emphasis on Therapy, Including Description of Operative Procedures , Ed. 2, Springfield, Ill., Charles C Thomas, Publisher, 1942. 11. Turner, G. G.: A Giant Gall-Stone Impacted in the Colon and Causing Acute Obstruction , Brit. J. Surg. 20:26, 1932. 12. Rigler, L. G.; Borman, C. N., and Noble, J. F.: Gallstone Obstruction: Pathogenesis and Roentgen Manifestations , J. A. M. A. 117:1753, 1941. 13. Courvoisier, L. G.: Casuistisch-statistische Beiträge zur Pathologie und Chirurgie der Gallenwege , Leipzig, F. C. W. Vogel, 1890, Vol. 12. 14. Vin Zant, L. E., and Hibbard, J. S.: Recurrent Ileus Due to Gallstones , J. Kansas M. Soc. 50:17, 1949. 15. Maingot, R.: Abdominal Operations , Ed. 3, New York, Appleton-Century-Crofts, Inc., 1955.

Journal

A.M.A. Archives Surgery – American Medical Association

Published: Apr 1, 1958

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