Surgical management of gallstone ileus after one anastomosis gastric bypass: A case report

Abstract

BACKGROUND

Gallstone ileus following one anastomosis gastric bypass (OAGB) is an exceptionally rare complication. The presented case report aims to highlight the unique occurrence of this condition and its surgical management. Understanding the clinical presentation, diagnostic challenges and successful surgical intervention in such cases is crucial for healthcare professionals involved in bariatric surgery.

CASE SUMMARY

We present a case report of gallstone ileus following OAGB and discuss its diagnosis and surgical management. A 66-year-old female with a history of OAGB presented to the emergency room with symptoms of small bowel obstruction. Computed tomography scan revealed a gallstone impacted in the distal ileum, causing obstruction. The patient underwent a laparoscopically assisted enterolithotomy, during which the gallstone was extracted and the enterotomy was closed. The patient had an uneventful recovery and was discharged on postoperative day four.

CONCLUSION

Gallstone ileus should be considered as a possible complication after OAGB, and prompt surgical intervention is usually required for its management. This case report contributes to the limited existing literature, providing insights into the management of this uncommon complication.

Keywords: Gallstone ileus; One anastomosis gastric bypass; Bariatric surgery; Intestinal occlusion; Bilio-digestive fistula; Enterolithotomy; Case report

Core Tip: Gallstone ileus is a rare but serious complication that can occur after bariatric surgery, including one anastomosis gastric bypass (OAGB). Prompt diagnosis and appropriate surgical management are crucial for successful outcomes. In this case report, we present a rare instance of gallstone ileus after OAGB, highlighting the importance of considering this condition in patients presenting with small bowel obstruction symptoms post-bariatric surgery. A laparoscopically assisted enterolithotomy was performed, leading to the successful extraction of the gallstone and subsequent resolution of symptoms. Surgeons should be aware of the increased risk of cholelithiasis after bariatric surgery and consider preventive measures or early intervention to minimize the occurrence of gallstone-related complications.