RESUMO
BACKGROUND: Gallstone ileus is caused by the exit of a gallstone from the gallbladder or bile duct into the small intestine, resulting in bowel obstruction if this stone becomes lodged in a small bowel loop. CLINICAL CASE: The case is presented of a 78 year-old woman with an episode of intestinal obstruction. After studying the main cause of the obstruction, it was decided to perform a laparotomy where a gallstone located in the terminal ileum was causing the obstruction. No fistula was observed between the gallbladder and the bile duct and the intestinal tract. It is important to note the history of an endoscopic retrograde cholangiopancreatography performed a few months earlier, as it would probably be the cause of the passage of the gallstone to the small bowel. CONCLUSION: Few reports of gallstone ileus have been described in the literature after performing an endoscopic retrograde cholangiopancreatography. In these cases, the intestinal obstruction usually occurs several months after the endoscopic retrograde cholangiopancreatography, so the diagnosis is often delayed. Surgery is usually the definitive treatment and it consists of the removal the stone by enterotomy and performing a cholecystectomy. Biliary enteric fistula repair is not necessary since this does not form.
Assuntos
Colangiopancreatografia Retrógrada Endoscópica , Cálculos Biliares/complicações , Obstrução Intestinal/etiologia , Complicações Pós-Operatórias/etiologia , Idoso , Colangiopancreatografia Retrógrada Endoscópica/efeitos adversos , Feminino , HumanosRESUMO
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Assuntos
Humanos , Masculino , Feminino , Adulto , Idoso , Eosinofilia/complicações , Enterite/complicações , Procedimentos Cirúrgicos do Sistema Digestório , Diagnóstico Diferencial , Obstrução Intestinal/cirurgia , Apendicite/cirurgiaAssuntos
Enterite/cirurgia , Eosinofilia/cirurgia , Gastrite/cirurgia , Dor Abdominal/etiologia , Adulto , Idoso , Apendicectomia , Apendicite/diagnóstico , Colectomia/métodos , Erros de Diagnóstico , Emergências , Enterite/diagnóstico , Eosinofilia/diagnóstico , Eosinófilos/patologia , Feminino , Gastrite/diagnóstico , Humanos , Ileíte/diagnóstico , Ileíte/patologia , Ileíte/cirurgia , Mucosa Intestinal/patologia , Obstrução Intestinal/etiologia , Leucocitose/etiologia , Músculo Liso/patologia , Vômito/etiologiaRESUMO
BACKGROUND: Littre's hernia is the presence of a Meckel diverticulum within an orifice in the abdominal wall. There are few cases published in the literature and its frequency is not well described. CLINICAL CASE: We present the case of a 74-year-old patient who arrived at the emergency service with clinical signs of intestinal obstruction caused by an incarcerated right inguinal hernia. Emergency surgery was performed using a preperitoneal approach. Within the hernia, 5 cm of small bowel containing a Meckel diverticulum was found. Therefore, we decided to extirpate the diverticulum and repair the hernia placing a polypropylene mesh. CONCLUSIONS: Meckel diverticulum is the persistence of the omphalomesenteric duct. It is usually asymptomatic, producing bleeding, infection or intestinal obstruction as the main symptoms.
