RESUMO
A gallstone ileus is an unusual form of bowel obstruction. Colonic gallstone ileus is rare, difficult to diagnose, and still has a high mortality rate. We present a case of biliary ileus caused by an impacted gallstone, causing necrosis and perforation of the rectosigmoid junction. A Hartmann's procedure was performed to treat the perforation and the obstruction. Cholecystectomy and closure of the cholecysto-colonic fistula were delayed until restoration of the intestinal continuity.
Assuntos
Cálculos Biliares/complicações , Íleus/etiologia , Obstrução Intestinal/etiologia , Idoso , Colecistectomia , Diagnóstico Diferencial , Cálculos Biliares/diagnóstico por imagem , Cálculos Biliares/cirurgia , Humanos , Íleus/diagnóstico por imagem , Íleus/cirurgia , Obstrução Intestinal/diagnóstico por imagem , Obstrução Intestinal/cirurgia , Masculino , Tomografia Computadorizada por Raios XRESUMO
An isolated gall-bladder injury after blunt abdominal trauma is rare. Intraluminal bleeding with a perforation and an intra-abdominal haemorrhage is even rarer. Early diagnosis is difficult, even with a CT-scan or an US-scan available. Clinical suspicion, serial clinical examination and repeated imaging, can prevent mortality and morbidity. We present a case where laparoscopy was used to diagnose and treat an isolated gall-bladder lesion after blunt abdominal trauma.