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Íleo biliar: un reto diagnóstico y terapéutico. Presentación de un caso clínico

BACKGROUND: Gallstone ileus represents 4% of the causes of bowel obstruction in general population, but it increases to 25% in patients above 65 years of age. Gallstone ileus does not present with unique symptoms, making diagnosis difficult. It has a high mortality (12 to 27%) due to associated como...

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Autores principales: Reyes-Morales, Juan Manuel, Hernández-García, Laura Karina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Instituto Mexicano del Seguro Social 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10395987/
https://www.ncbi.nlm.nih.gov/pubmed/36542794
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author Reyes-Morales, Juan Manuel
Hernández-García, Laura Karina
author_facet Reyes-Morales, Juan Manuel
Hernández-García, Laura Karina
author_sort Reyes-Morales, Juan Manuel
collection PubMed
description BACKGROUND: Gallstone ileus represents 4% of the causes of bowel obstruction in general population, but it increases to 25% in patients above 65 years of age. Gallstone ileus does not present with unique symptoms, making diagnosis difficult. It has a high mortality (12 to 27%) due to associated comorbidities and diagnostic delay. The aim of this case report is to communicate the importance of prompt diagnosis and surgical management of gallstone ileus. CLINICAL CASE: It is presented the clinical case of a 67-year-old female patient with a history of long-standing diabetes mellitus without medical control, without previous surgical history, who began suffering 2 days prior to admission to the emergency room with signs and symptoms of intestinal occlusion. She was given medical management without improvement and diagnostic delay of mechanical intestinal occlusion that was surgically intervened 7 days after the onset of clinical symptoms, finding gallstone ileus in the exploratory laparotomy, with satisfactory resolution of the pathology despite the diagnostic delay. CONCLUSIONS: Gallstone ileus is a difficult clinical entity to diagnose and therefore requires a high index of suspicion. The aim of gallstone ileus treatment is to release the obstruction, which is done through enterolithotomy. It is the recommended technique for gallstone ileus management because of its lower morbidity and mortality, compared with the other techniques.
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spelling pubmed-103959872023-08-04 Íleo biliar: un reto diagnóstico y terapéutico. Presentación de un caso clínico Reyes-Morales, Juan Manuel Hernández-García, Laura Karina Rev Med Inst Mex Seguro Soc Casos Clínicos BACKGROUND: Gallstone ileus represents 4% of the causes of bowel obstruction in general population, but it increases to 25% in patients above 65 years of age. Gallstone ileus does not present with unique symptoms, making diagnosis difficult. It has a high mortality (12 to 27%) due to associated comorbidities and diagnostic delay. The aim of this case report is to communicate the importance of prompt diagnosis and surgical management of gallstone ileus. CLINICAL CASE: It is presented the clinical case of a 67-year-old female patient with a history of long-standing diabetes mellitus without medical control, without previous surgical history, who began suffering 2 days prior to admission to the emergency room with signs and symptoms of intestinal occlusion. She was given medical management without improvement and diagnostic delay of mechanical intestinal occlusion that was surgically intervened 7 days after the onset of clinical symptoms, finding gallstone ileus in the exploratory laparotomy, with satisfactory resolution of the pathology despite the diagnostic delay. CONCLUSIONS: Gallstone ileus is a difficult clinical entity to diagnose and therefore requires a high index of suspicion. The aim of gallstone ileus treatment is to release the obstruction, which is done through enterolithotomy. It is the recommended technique for gallstone ileus management because of its lower morbidity and mortality, compared with the other techniques. Instituto Mexicano del Seguro Social 2023 /pmc/articles/PMC10395987/ /pubmed/36542794 Text en © 2023 Revista Médica del Instituto Mexicano del Seguro Social. https://creativecommons.org/licenses/by-nc-nd/4.0/Esta obra está bajo una Licencia Creative Commons Atribución-NoComercial-SinDerivar 4.0 Internacional.
spellingShingle Casos Clínicos
Reyes-Morales, Juan Manuel
Hernández-García, Laura Karina
Íleo biliar: un reto diagnóstico y terapéutico. Presentación de un caso clínico
title Íleo biliar: un reto diagnóstico y terapéutico. Presentación de un caso clínico
title_full Íleo biliar: un reto diagnóstico y terapéutico. Presentación de un caso clínico
title_fullStr Íleo biliar: un reto diagnóstico y terapéutico. Presentación de un caso clínico
title_full_unstemmed Íleo biliar: un reto diagnóstico y terapéutico. Presentación de un caso clínico
title_short Íleo biliar: un reto diagnóstico y terapéutico. Presentación de un caso clínico
title_sort íleo biliar: un reto diagnóstico y terapéutico. presentación de un caso clínico
topic Casos Clínicos
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10395987/
https://www.ncbi.nlm.nih.gov/pubmed/36542794
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