Gallstone ileus presenting as intussusception: A case report

Rahul M Prasad; Katrina M Weimer; Arunkumar Baskara

doi:10.1016/j.ijscr.2016.11.036

Gallstone ileus presenting as intussusception: A case report

Int J Surg Case Rep. 2017:30:37-39. doi: 10.1016/j.ijscr.2016.11.036. Epub 2016 Nov 22.

Authors

Rahul M Prasad¹, Katrina M Weimer², Arunkumar Baskara²

Affiliations

¹ The University of Toledo College of Medicine and Life Sciences, 3000 Arlington Ave, Toledo, OH 43614, USA. Electronic address: Rahul.Prasad@rockets.utoledo.edu.
² The University of Toledo College of Medicine and Life Sciences, 3000 Arlington Ave, Toledo, OH 43614, USA.

Abstract

Background: Gallstone ileus is a complication of acute cholecystitis that accounts for 25% of bowel obstruction cases in the elderly. To our knowledge, only one other case of gallstone ileus presenting as intussusception has been reported in the literature, and involved non-operative management with an unfavorable outcome.

Case presentation: Here we report the case of 69year old woman presenting with symptoms of acute small bowel obstruction with a surgical history significant for cholecystectomy 30 years prior. Computed tomographic imaging showed a target sign in the small bowel consistent with intussusception, but intraoperative diagnosis revealed this to be a gallstone. A simple enterolithotomy was conducted and the patient has since been symptom free.

Discussion: Gallstone ileus has a high mortality rate (12-17%) and is an important differential diagnosis to consider, especially as the elderly population throughout the world continues to grow.

Conclusion: As radiographic features of gallstones are variable we suggest maintaining a high index of suspicion for gallstone ileus in any elderly patient presenting with SBO, even with a seemingly contradictory surgical history.

Keywords: Case report; Gallstone ileus; Geriatric surgery; Hepatobiliary; Intussusception; Small bowel obstruction.