Clinical—An 87-year-old woman presented with symptoms of generalised colicky abdominal pain with associated constipation and vomiting of 3-days duration. She had no previous abdominal surgery. Abdominal examination revealed a distended, tympanic abdomen that was diffusely tender, maximally over the left iliac fossa. Bowel sounds were reduced on auscultation. She was initially investigated with plain film radiology (Figure 1) and then with computerised tomography (CT; Figure 2). Laparotomy findings are shown in Figure 3. Figure 1. Plain film radiology Figure 2. Computerised tomography Figure 3. Intraoperative view of colotomy What is the diagnosis? Answer
Martin F. Intestinal obstruction due to gallstones. Annals of Surgery. 1912;55:725.Reisner R, Cohen J. Gallstone ileus: a review of 1001 reported cases. Am Surg. 1994;60(6):441-446.Anagnostopoulos GK, Sakorafas G, Kolettis T, et al. A case of gallstone ileus with an unusual impaction site and spontaneous evacuation. J Postgrad Med. 2004;50(1):55-56.Rigler L, Borman C, Noble J. Gallstone obstruction: pathogenesis and roentgen manifestations. JAMA. 1941;117:1753-1759.Ayantunde AA, Agrawal A. Gallstone ileus: diagnosis and management. World J Surg. 2007;31(6):1292-1297.G 00e1l I, Sz 00edv 00f3s J, Jaberansari M, Szab 00f3 Z. Laparoscopic cholecystectomy. Risk of missed pathology of other organs. Surg Endosc. 1998;12(6):825-827.Milsom J, MacKeigan J. Gallstone obstruction of the colon. Report of two cases and review of management. Dis. Colon Rectum. 1985;28(5):367-370.Kirchmayr W, M 00fchlmann G, Zitt M, et al. Gallstone ileus: rare and still controversial. ANZ J Surg. 2005;75(4):234-238.
Clinical—An 87-year-old woman presented with symptoms of generalised colicky abdominal pain with associated constipation and vomiting of 3-days duration. She had no previous abdominal surgery. Abdominal examination revealed a distended, tympanic abdomen that was diffusely tender, maximally over the left iliac fossa. Bowel sounds were reduced on auscultation. She was initially investigated with plain film radiology (Figure 1) and then with computerised tomography (CT; Figure 2). Laparotomy findings are shown in Figure 3. Figure 1. Plain film radiology Figure 2. Computerised tomography Figure 3. Intraoperative view of colotomy What is the diagnosis? Answer
Martin F. Intestinal obstruction due to gallstones. Annals of Surgery. 1912;55:725.Reisner R, Cohen J. Gallstone ileus: a review of 1001 reported cases. Am Surg. 1994;60(6):441-446.Anagnostopoulos GK, Sakorafas G, Kolettis T, et al. A case of gallstone ileus with an unusual impaction site and spontaneous evacuation. J Postgrad Med. 2004;50(1):55-56.Rigler L, Borman C, Noble J. Gallstone obstruction: pathogenesis and roentgen manifestations. JAMA. 1941;117:1753-1759.Ayantunde AA, Agrawal A. Gallstone ileus: diagnosis and management. World J Surg. 2007;31(6):1292-1297.G 00e1l I, Sz 00edv 00f3s J, Jaberansari M, Szab 00f3 Z. Laparoscopic cholecystectomy. Risk of missed pathology of other organs. Surg Endosc. 1998;12(6):825-827.Milsom J, MacKeigan J. Gallstone obstruction of the colon. Report of two cases and review of management. Dis. Colon Rectum. 1985;28(5):367-370.Kirchmayr W, M 00fchlmann G, Zitt M, et al. Gallstone ileus: rare and still controversial. ANZ J Surg. 2005;75(4):234-238.
Clinical—An 87-year-old woman presented with symptoms of generalised colicky abdominal pain with associated constipation and vomiting of 3-days duration. She had no previous abdominal surgery. Abdominal examination revealed a distended, tympanic abdomen that was diffusely tender, maximally over the left iliac fossa. Bowel sounds were reduced on auscultation. She was initially investigated with plain film radiology (Figure 1) and then with computerised tomography (CT; Figure 2). Laparotomy findings are shown in Figure 3. Figure 1. Plain film radiology Figure 2. Computerised tomography Figure 3. Intraoperative view of colotomy What is the diagnosis? Answer
Martin F. Intestinal obstruction due to gallstones. Annals of Surgery. 1912;55:725.Reisner R, Cohen J. Gallstone ileus: a review of 1001 reported cases. Am Surg. 1994;60(6):441-446.Anagnostopoulos GK, Sakorafas G, Kolettis T, et al. A case of gallstone ileus with an unusual impaction site and spontaneous evacuation. J Postgrad Med. 2004;50(1):55-56.Rigler L, Borman C, Noble J. Gallstone obstruction: pathogenesis and roentgen manifestations. JAMA. 1941;117:1753-1759.Ayantunde AA, Agrawal A. Gallstone ileus: diagnosis and management. World J Surg. 2007;31(6):1292-1297.G 00e1l I, Sz 00edv 00f3s J, Jaberansari M, Szab 00f3 Z. Laparoscopic cholecystectomy. Risk of missed pathology of other organs. Surg Endosc. 1998;12(6):825-827.Milsom J, MacKeigan J. Gallstone obstruction of the colon. Report of two cases and review of management. Dis. Colon Rectum. 1985;28(5):367-370.Kirchmayr W, M 00fchlmann G, Zitt M, et al. Gallstone ileus: rare and still controversial. ANZ J Surg. 2005;75(4):234-238.
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