Nuño-Guzmán CM, Marín-Contreras ME, Figueroa-Sánchez M, Corona JL. Gallstone ileus, clinical presentation, diagnostic and treatment approach. World J Gastrointest Surg 2016; 8(1): 65-76 [PMID: 26843914 DOI: 10.4240/wjgs.v8.i1.65]
Corresponding Author of This Article
Carlos M Nuño-Guzmán, MD, MSc, Department of General Surgery, Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Calle Hospital No. 278, Sector Hidalgo, Guadalajara CP 44280, Jalisco, México. carlosnunoguzman@hotmail.com
Research Domain of This Article
Surgery
Article-Type of This Article
Review
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Jan 27, 2016; 8(1): 65-76 Published online Jan 27, 2016. doi: 10.4240/wjgs.v8.i1.65
Gallstone ileus, clinical presentation, diagnostic and treatment approach
Carlos M Nuño-Guzmán, María Eugenia Marín-Contreras, Mauricio Figueroa-Sánchez, Jorge L Corona
Carlos M Nuño-Guzmán, Department of General Surgery, Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Guadalajara CP 44280, Jalisco, México
Carlos M Nuño-Guzmán, Department of General Surgery, Unidad Médica de Alta Especialidad, Hospital de Especialidades del Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara CP 44340, Jalisco, México
María Eugenia Marín-Contreras, Department of Gastrointestinal Endoscopy, Unidad Médica de Alta Especialidad, Hospital de Especialidades del Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara CP 44340, Jalisco, México
Mauricio Figueroa-Sánchez, Jorge L Corona, Department of Radiology, Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Guadalajara CP 44280, Jalisco, México
Author contributions: Nuño-Guzmán CM and Marín-Contreras ME contributed to the conception and design of the paper, the writing of the paper and the final revision; Nuño-Guzmán CM, Marín-Contreras ME, Figueroa-Sánchez M and Corona JL contributed to the literature search, the writing of the paper and the final revision of the paper.
Conflict-of-interest statement: There are no disclosures.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Carlos M Nuño-Guzmán, MD, MSc, Department of General Surgery, Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Calle Hospital No. 278, Sector Hidalgo, Guadalajara CP 44280, Jalisco, México. carlosnunoguzman@hotmail.com
Telephone: +52-33-39424400 Fax: +52-33-36690229
Received: July 4, 2015 Peer-review started: July 9, 2015 First decision: September 22, 2015 Revised: November 11, 2015 Accepted: December 7, 2015 Article in press: December 8, 2015 Published online: January 27, 2016 Processing time: 201 Days and 8.1 Hours
Abstract
Gallstone ileus is a mechanical intestinal obstruction due to gallstone impaction within the gastrointestinal tract. Less than 1% of cases of intestinal obstruction are derived from this etiology. The symptoms and signs of gallstone ileus are mostly nonspecific. This entity has been observed with a higher frequency among the elderly, the majority of which have concomitant medical illness. Cardiovascular, pulmonary, and metabolic diseases should be considered as they may affect the prognosis. Surgical relief of gastrointestinal obstruction remains the mainstay of operative treatment. The current surgical procedures are: (1) simple enterolithotomy; (2) enterolithotomy, cholecystectomy and fistula closure (one-stage procedure); and (3) enterolithotomy with cholecystectomy performed later (two-stage procedure). Bowel resection is necessary in certain cases after enterolithotomy is performed. Large prospective laparoscopic and endoscopic trials are expected.
Core tip: A review of the symptoms and signs of gallstone ileus is presented. The findings, advantages and limitations of the different diagnostic modalities such as plain abdominal radiographs, upper gastrointestinal series, ultrasound, computed tomography, magnetic resonance and endoscopy are reviewed. The different surgical options are discussed. Laparoscopic and endoscopic procedures are widely reviewed. Current data on morbidity and mortality are included.
