Resumo
Colonic obstruction is a very rare complication of gallstone disease. We describe two cases of colonic obstruction by gallstone in old age women, in which the final diagnosis was made on surgery. In one it was found a cholecystocolic fistula and a stone impacted in the sigmoid colon which was milked until the cecum, where it was removed through a cecolithotomy. In the other there was a cholecystoduodenal fistula, the stone was impacted in the sigmoid colon and in association there was a colonic necrosis, treated by colectomy, ileostomy and mucous fistula, During colonic mobilization a colecystoduodenal fistula was exposed, making necessary to perform a cholecystectomy and fistula repair. Both patients died in sepsis.
Colonic gallstone ileus; Gallstone; Biliary enteric fistula; Diagnosis; Therapy; Case report
Colonic gallstone ileus; Gallstone; Biliary enteric fistula; Diagnosis; Therapy; Case report
RELATOS DE CASOS
Íleo biliar colônico
Colonic gallstone ileus
João Batista Cardoso, TCBC-SPI; Omar Féres, TCBC-SPI; José Ivan de Andrade, TCBC-SPII
IMédico Assistente do Serviço de Cirurgia da Unidade de Emergência do HC - FMRPUSP
IIProfessor Doutor do Departamento de Cirurgia, Ortopedia e Traumatologia da FMRPUSP. Coordenador do Serviço de Cirurgia da Unidade de Emergência do HC - FMRPUSP
Endereço para correspondência Endereço para correspondência: Dr. João Batista Cardoso Rua dos Trabalhadores, 926 14870-000 - Jaboticabal- SP E-mail: jobaca.jal@netsite.com.br
ABSTRACT
Colonic obstruction is a very rare complication of gallstone disease. We describe two cases of colonic obstruction by gallstone in old age women, in which the final diagnosis was made on surgery. In one it was found a cholecystocolic fistula and a stone impacted in the sigmoid colon which was milked until the cecum, where it was removed through a cecolithotomy. In the other there was a cholecystoduodenal fistula, the stone was impacted in the sigmoid colon and in association there was a colonic necrosis, treated by colectomy, ileostomy and mucous fistula, During colonic mobilization a colecystoduodenal fistula was exposed, making necessary to perform a cholecystectomy and fistula repair. Both patients died in sepsis.
Key words: Colonic gallstone ileus; Gallstone; Biliary enteric fistula; Diagnosis; Therapy; Case report,
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Full text available only in PDF format.
Recebido em 28/10/98
Aceito para publicação em 14/6/99
Trabalho realizado no Serviço de Cirurgia da Unidade de Emergência do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo - HC - FMRPUSP.
- 1. Rayford TS. Intestinal obstruction caused by gallstones. Am J Surg 1962;102:383-394.
- 2. Fisher WE, Holden Cr, Salt WB. Gallstone obstruction of the colon. Through treatment prevents serious complications. Postgrad Med 1992;249-251.
- 3. Phillips DE, Doran J. Obstruction of the colon by a giant gallstone. Br J Hosp Med 1986; 36:444.
- 4. Day EA, Marks C. Gallstone ileus. Review of the literature and presentation of thirty-four new cases. Am J Surg 1975; 129:552-558.
- 5. Borman CN, Riegler LG. Spontaneous internal biliary fistula and gallstone obstruction with particular reference to the roentgenologic diagnosis. Surgery 1937;1:349
Datas de Publicação
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Publicação nesta coleção
26 Jan 2010 -
Data do Fascículo
Ago 1999
Histórico
-
Aceito
14 Jun 1999 -
Recebido
28 Out 1998
