RESUMO
Gallstone ileus is a rare cause of mechanical bowel obstruction. The attendant lack of awareness by the clinician will not only result in the diagnosis being made intraoperatively but will also affect the adequacy of the preoperative preparation of these ill patients. These patients are often elderly, septic and have significant concomitant medical illnesses. Recently two patients with gallstone ileus were managed with enterolithotomy and primary repair of the cholecyst-duodenal fistula at the University Hospital of the West Indies, Jamaica. Their clinical presentations and progress are described along with a review of the classical clinical course, radiological features, and operative choices available. (AU)
Assuntos
Humanos , Pessoa de Meia-Idade , Idoso , Feminino , Fístula Biliar/cirurgia , Colelitíase/complicações , Duodenopatias/cirurgia , Doenças da Vesícula Biliar/cirurgia , Fístula Intestinal/cirurgia , Obstrução Intestinal/etiologia , Fístula Biliar/complicações , Colecistectomia , Colelitíase/cirurgia , Duodenopatias/complicações , Duodeno/cirurgia , Fístula Intestinal/complicações , Obstrução Intestinal/cirurgiaRESUMO
A case is presented in which a pancreatico-bilary fistula followed gastrectomy for a chronic benign gastric ulcer. The common bile duct and the pancreatic duct are shown to be abnormally placed and draining into the third part of the duodenum as can rarely occur. It is concluded that the fistula was originally an internal one, and was unmasked by the operation. The patient has done well after choledochoduodenostomy and pancreatico-gastrostomy (AU)
