Gallstone Ileus with Cholecystogastric Fistula in an Older Female
  • Roger Taylor
    Emergency Medicine Department, Charleston Area Medical Center, Charleston, WV, USA
  • Nnennaya Opara
    Emergency Medicine Department, Charleston Area Medical Center, Charleston, WV, USA; Institute for Academic Medicine, Charleston Area Medical Center, Charleston, WV, USA https://orcid.org/0000-0002-2761-2424
  • Taylor Simmerman
    Emergency Medicine Department, Charleston Area Medical Center, Charleston, WV, USA

Keywords

Peptic ulcer, gallstone ileus, cholecystogastric fistula, intestinal obstruction, Bouveret’s syndrome

Abstract

Cholecystogastric fistulas are a rare but life-threatening complication of cholelithiasis. This medical condition has been explained in detail in several cases in the medical literature. However, there is still conflicting debate on how well to effectively manage patients with such a complex medical condition. We present a 70-year-old Caucasian female with complaints of intermittent dull non-radiating abdominal pain. Her pain started abruptly after breakfast. Patient took some acetaminophen which alleviated her symptom. Several days later, pains return but at this time it was associated with constipation. Patient’s primary care physician (PCP) suspected peptic ulcer disease, which was quickly ruled out following negative result of Helicobacter pylori breath test. The PCP advised patient to visit the emergency department for further investigations to rule out/in possible gallstone ileus causing intestinal obstruction, or Bouveret’s syndrome.

VIEW THE ENTIRE ARTICLE

References

  • Bhuiya FA, Pitts SR, McCaig LF. Emergency department visits for chest pain and abdominal pain: United States, 1999–2008. NCHS Data Brief, No. 43. Hyattsville, MD: National Center for Health Statistics; 2020.
  • Taylor MR, Lalani N. Adult small bowel obstruction. Acad Emerg Med 2013;20(6):527–544. doi:10.1111/acem.12150
  • Menzies D, Ellis H. Intestinal obstruction from adhesions – how big is the problem? Ann R Coll Surg Engl 1990;72(1):60–63.
  • Halabi WJ, Kang CY, Ketana N, Lafaro KJ, Nguyen VQ, Stamos MJ, et al. Surgery for gallstone ileus: a nationwide comparison of trends and outcomes. Ann Surg 2014;259(2):329–335. doi:10.1097/SLA.0b013e31827eefed
  • Townsend CM, Beauchamp RD, Evers BM, Mattox KL, editors. Sabiston textbook of surgery. 18th ed. New York: Saunders Elsevier; 2008.
  • Williams NS, Bulstrode CJK, O’Connell PR, editors. Bailey & Love’s short practice of surgery. 26th ed. Boca Raton: CRC Press; 2013.
  • Ramos GP, Chiang NE. Bouveret’s syndrome. N Engl J Med 2018;378:1335. doi: 10.1056/NEJMicm1711592
  • Hernandez C, Heuman D, Vlahcevid ZR. Pathophysiology of disease associated with deficiency of bile acids. Principles Pract Gastroenterol Hepatol 1998:384–395.
  • Summerton SL, Hollander AC, Stassi J, Rosenberg HK, Carroll SF. US case of the day. Gallstone ileus. Radiographics 1995;15(2):493–495.
  • van Hillo M, van der Vliet J, Wiggers T, Obertop H, Terpstra OT, Greep JM. Gallstone obstruction of the intestine: an analysis of ten patients and a review of the literature. Surgery 1987;101(3):273–276.

    • Views: 481
    HTML downloads: 126
    PDF downloads: 304

    Published: 2022-04-29
    Issue: 2022: Vol 9 No 4 (view)

    How to cite:
    1.
    Taylor R, Opara N, Simmerman T. Gallstone Ileus with Cholecystogastric Fistula in an Older Female . EJCRIM 2022;9 doi:10.12890/2022_003345.