Resumo
Treatment, morbidity and mortality of patients with gallstone ileus depend on an accurate diagnosis made in time, and also on a more adequate therapeutic option.A detailed clinical evaluation is fundamental for such diagnosis. Complementary exams like a simple radiological study of the abdomen, high and low endoscopies, an ultrasonography, and a tomography can also be performed. The therapeutic options include the removal of the obstructive factor separately, the performance of a treatment in two separate stages, or the performance of a complete treatment (removal of the calculus, cholecystectomy, and the closing of the fistula).This study aims to present a case report of an elderly man of high surgical risk, presenting gallstone ileus. He was submitted to an isolated videoassisted enterolithotomy through a minilaparotomy. Taking into consideration the patient’s advanced age and the lack of evidence as to other biliary associated pathologies, the chosen treatment seemed to be a good alternative. The evolution was good, and after an 8 month follow-up the patient was found well and with no biliary symptoms whatsoever.
Gallstone Ileus; Biliary enteric fistula; Diagnosis; Therapy
Gallstone Ileus; Biliary enteric fistula; Diagnosis; Therapy
RELATOS DE CASOS
Íleo biliar: enterolitotomia videoassistida
Gallstone ileus: videoassisted enterolithotomy
Álvaro Queiroz de Godoy, TCBC-PRI; Oscar Tecla JuniorII; André Reichert da Silva GodoyIII
ICirurgião do Aparelho Digestivo do Hospital Evangélico, Santa Casa de Misericórdia e Gastrocentro de Londrina - PR
IIGastroenterologista do Hospital Evangélico, Santa Casa de Misericórdia e Gastrocentro de Londrina - PR
IIIAcadêmico da Faculdade de Medicina da Fundação Educacional Serra dos Órgãos - Teresópolis - RJ
Endereço para correspondência Endereço para correspondência: Dr. Álvaro Queiroz de Godoy Av. Bandeirantes, 324 86010-010 - Londrina PR
ABSTRACT
Treatment, morbidity and mortality of patients with gallstone ileus depend on an accurate diagnosis made in time, and also on a more adequate therapeutic option.A detailed clinical evaluation is fundamental for such diagnosis. Complementary exams like a simple radiological study of the abdomen, high and low endoscopies, an ultrasonography, and a tomography can also be performed. The therapeutic options include the removal of the obstructive factor separately, the performance of a treatment in two separate stages, or the performance of a complete treatment (removal of the calculus, cholecystectomy, and the closing of the fistula).This study aims to present a case report of an elderly man of high surgical risk, presenting gallstone ileus. He was submitted to an isolated videoassisted enterolithotomy through a minilaparotomy. Taking into consideration the patients advanced age and the lack of evidence as to other biliary associated pathologies, the chosen treatment seemed to be a good alternative. The evolution was good, and after an 8 month follow-up the patient was found well and with no biliary symptoms whatsoever.
Key words: Gallstone Ileus; Biliary enteric fistula; Diagnosis; Therapy.
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Recebido em 7/12/1199
Aceito para publicação em 29/5/2000
Trabalho realizado no Gastrocentro de Londrina-PR
- 1. Rodriguez-Sanjuan JC, Casado F, Fernandez MJ et al. Cholecystectomy and fistula closure versus enterolithotomy alone in gallstone ileus Br J Surg 1997 ; 84 (5) : 634 - 637.
- 2. Schumacher G, Keck H, Neuhaus P. Die cholecystoduodenale Fistel mit nachfolgendem Gallensteinileus: Fallbeschreibung eines ungewöhnlichen Verlaufs Zentralbl Chir Leipzig 1996; 121 (5) : 408-411.
- 3. Pérez-Morera A, Pérez-Díaz D, Calvo Serrano M, et al. Obstrucción aguda de colon secundaria a litiasis biliar Rev Esp Enf Digest 1996; 88 (11): 805-808.
- 4. Kosorok P Bouverets Syndrome ( Gallstone ileus ) a minefield Br J Clin Pract 1996; 50 (1): 59-60.
- 5. Oikarinen H, Päivänsalo M, Tikkakoski T, Saarela A Radiological findings in biliary fistula and gallstone ileus Acta Radiologica 1996; 37 (6) : 917-922.
Endereço para correspondência:
Datas de Publicação
-
Publicação nesta coleção
18 Dez 2008 -
Data do Fascículo
Dez 2000
Histórico
-
Recebido
07 Dez 1999 -
Aceito
29 Maio 2000