Evaluation and diagnosis of gallstone ileus using point of care ultrasound in the Emergency Department
https://doi.org/10.4081/ecj.2020.8570
Accepted: 28 October 2019
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A 75-year-old female presented to the Emergency Department (ED) with nausea, feculent emesis and abdominal distension. On previous visit the patient was diagnosed with a 2.2x1.9x1.1 cm ectopic gallstone in the mid small bowel without evidence of ileus or bowel obstruction and was subsequently discharged home. She returned 2 days later, abdominal plain radiographs revealed mildly dilated small bowel with air-fluid levels and a calcified mass in the right hemipelvis. Bedside ultrasound was performed and an air filled gallbladder with a fistulous tract was visualized. Dilated loops of bowel were visualized with an abnormal back and forth movement of intestinal contents, consistent with a small bowel obstruction. Patient went on to have an uncomplicated surgical extraction of the gallstone with resolution of her ileus. We would propose using point-of-care ultrasonography with abdominal plain films as an adjunct for evaluation and diagnosis of gallstone ileus in elderly patients.
Artioli G, Muri M, Praticò1 F. Gallstone ileus: literature review. Acta Biomed. 2016;87(3):40-4.
Buljevac M, Busic Z, Cabrijan Z. Sonographic Diagnosis of Gallstone Ileus. J Ultrasound Med. 2004;23:1395–8. DOI: https://doi.org/10.7863/jum.2004.23.10.1395
Reisner R, Cohen J. Gallstone ileus: a review of 1001 reported cases. The American Surgeon. 1994;60(6):441-6
Rodríguez J, Codina A, Gironès J. Gallstone Ileus results of analysis of a series of 40 patients. Gastroenterologia y hepatologia. 2001;24(10):489-94.
Chang L, Chang M, Chang H. Clinical and radiological diagnosis of gallstone ileus: a mini review. Emerg Radiol. 2018;25:189–96. DOI: https://doi.org/10.1007/s10140-017-1568-5
Chuah P, Curtis J, Misra N. Pictorial review: the pearls and pitfalls of the radiological manifestations of gallstone ileus. Abdom Radiol. 2017;42:1169–75. DOI: https://doi.org/10.1007/s00261-016-0996-0
Svarholm E, Andren-Sandberg A, Evander A, Diagnosis and treatment of gallstone ileus: report of 83 cases. Acta Chir Scand. 1982;148:435–8.
Schutte H, Bastias J, Csendes A. Gallstone ileus. Hepatogastroenterology. 1992;39:562–5.
Rotaru M, Necula A, Caraiani1 C. Point-of-care ultrasound in management of gallstone ileus– a case report. Med Ultrason 2019;21(2)197-9. DOI: https://doi.org/10.11152/mu-1731
Stagnitti F, Tudisco A, Ceci F, Nicodemi S. Biliodigestive fistulae and gallstone ileus: diagnostic and therapeutic considerations. Our experience. Giornale di Chirurgia - Journal of Surgery. 2014;35(9):235–8.
Lassandro F. Gagliardi N. Scuderi M.Gallstone ileus analysis of radiological findings in 27 patients. Eur J Radiol 2004;50(1):23-9. DOI: https://doi.org/10.1016/j.ejrad.2003.11.011
Ripolle ́s T, Miguel-Dasit A, Errando J. Gallstone ileus: increased diagnostic sensitivity by combining plain film and ultrasound. Abdom Imaging. 2001;26:401–5. DOI: https://doi.org/10.1007/s002610000190
Chawla A, Bosco J, Lim T. Imaging of acute cholecystitis and cholecystitis-associated complications in the emergency setting. Singapore Med J. 2015;56(8):438-44. DOI: https://doi.org/10.11622/smedj.2015120
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