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Gallstone ileus displaying the typical Rigler triad and an occult second ectopic stone: A case report
RATIONALE: Gallstone ileus is a rare complication of cholecystolithiasis. It has a female predominance and can result in high mortality rates. PATIENT CONCERNS: A 71-year-old woman complaining of recurrent vomiting and vague epigastralgia for > 2 weeks presented to our department. DIAGNOSIS: Base...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5690756/ https://www.ncbi.nlm.nih.gov/pubmed/29137063 http://dx.doi.org/10.1097/MD.0000000000008541 |
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author | Wang, Li Dong, Ping Zhang, Yi Tian, Bole |
author_facet | Wang, Li Dong, Ping Zhang, Yi Tian, Bole |
author_sort | Wang, Li |
collection | PubMed |
description | RATIONALE: Gallstone ileus is a rare complication of cholecystolithiasis. It has a female predominance and can result in high mortality rates. PATIENT CONCERNS: A 71-year-old woman complaining of recurrent vomiting and vague epigastralgia for > 2 weeks presented to our department. DIAGNOSIS: Based on her physical examination, laboratory test results and radiographic findings (the typical Rigler's triad), she was diagnosed with gallstone ileus caused by multiple ectopic stones. INTERVENTIONS: After correction of electrolyte imbalances through parenteral nutrition and fluid management, the patient's condition improved and she underwent enterolithotomy. A 5.3-cm stone located 40 cm from the ligament of Treitz was extracted, and a second ectopic stone, not detected on any imaging modality, was found during laparotomy. Given her comorbidities and overall poor condition, cholecystectomy and fistula repair were not performed. OUTCOMES: The patient gradually recovered postoperatively. LESSONS: Clinical symptoms including epigastralgia with nausea and vomiting, and abdominal CT findings of Rigler's triad (ectopic gallstone, bowel obstruction, and pneumobilia) may lead to early diagnosis of gallstone ileus and enterolithotomy may be the preferred treatment for this condition in the elderly. Laparotomy should involve a systematic and meticulous search for the presence of additional ectopic enteric stones. |
format | Online Article Text |
id | pubmed-5690756 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-56907562017-11-28 Gallstone ileus displaying the typical Rigler triad and an occult second ectopic stone: A case report Wang, Li Dong, Ping Zhang, Yi Tian, Bole Medicine (Baltimore) 4500 RATIONALE: Gallstone ileus is a rare complication of cholecystolithiasis. It has a female predominance and can result in high mortality rates. PATIENT CONCERNS: A 71-year-old woman complaining of recurrent vomiting and vague epigastralgia for > 2 weeks presented to our department. DIAGNOSIS: Based on her physical examination, laboratory test results and radiographic findings (the typical Rigler's triad), she was diagnosed with gallstone ileus caused by multiple ectopic stones. INTERVENTIONS: After correction of electrolyte imbalances through parenteral nutrition and fluid management, the patient's condition improved and she underwent enterolithotomy. A 5.3-cm stone located 40 cm from the ligament of Treitz was extracted, and a second ectopic stone, not detected on any imaging modality, was found during laparotomy. Given her comorbidities and overall poor condition, cholecystectomy and fistula repair were not performed. OUTCOMES: The patient gradually recovered postoperatively. LESSONS: Clinical symptoms including epigastralgia with nausea and vomiting, and abdominal CT findings of Rigler's triad (ectopic gallstone, bowel obstruction, and pneumobilia) may lead to early diagnosis of gallstone ileus and enterolithotomy may be the preferred treatment for this condition in the elderly. Laparotomy should involve a systematic and meticulous search for the presence of additional ectopic enteric stones. Wolters Kluwer Health 2017-11-10 /pmc/articles/PMC5690756/ /pubmed/29137063 http://dx.doi.org/10.1097/MD.0000000000008541 Text en Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nd/4.0 This is an open access article distributed under the Creative Commons Attribution-NoDerivatives License 4.0, which allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author. http://creativecommons.org/licenses/by-nd/4.0 |
spellingShingle | 4500 Wang, Li Dong, Ping Zhang, Yi Tian, Bole Gallstone ileus displaying the typical Rigler triad and an occult second ectopic stone: A case report |
title | Gallstone ileus displaying the typical Rigler triad and an occult second ectopic stone: A case report |
title_full | Gallstone ileus displaying the typical Rigler triad and an occult second ectopic stone: A case report |
title_fullStr | Gallstone ileus displaying the typical Rigler triad and an occult second ectopic stone: A case report |
title_full_unstemmed | Gallstone ileus displaying the typical Rigler triad and an occult second ectopic stone: A case report |
title_short | Gallstone ileus displaying the typical Rigler triad and an occult second ectopic stone: A case report |
title_sort | gallstone ileus displaying the typical rigler triad and an occult second ectopic stone: a case report |
topic | 4500 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5690756/ https://www.ncbi.nlm.nih.gov/pubmed/29137063 http://dx.doi.org/10.1097/MD.0000000000008541 |
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