Novosti
Khirurgii
This journal is
indexed in Scopus









Year 2015 Vol. 23 No 1

CASE REPORTS

DOI: http://dx.doi.org/10.18484/2305-0047.2015.1.112   |  

Y.V. SLABADZIN, L.I. NIKITINA, I.I. PAKLAK-VOLSKY, S.V. GNIPEL, M.P. RUDENKOV, I.I. PRIBUSHENA

GALLSTONE ILEUS

SE "The Republican Clinical Medical Centre of the Administration of the President of the Republic of Belarus", Minsk,
The Republic of Belarus

A clinical case of gallstone ileus accompanied by cholecystoduodenal fistula and tactics of treatment of this pathology in a certain clinical situation is described in the article.
A 74-year-old woman was hospitalized to the center with the diagnosis of chronic pancreatitis, exacerbation; complaints of moderate pains in the epigastrium and paraumbilical area, nausea and single plentiful vomiting within one day. After instrumental examination including the abdominal ultrasound, fibrogastroduodenoscopy, abdominal CT scan the diagnosis of cholecystoduodenal fistula and gallstone ileus was made. In operative intervention performance of laparoscopy revealed the site of obstruction of the small intestine. Considering the age of the patient and the accompanying pathology as well as the absence of duodenal and gallbladder inflammation, only enterolithotomy was done. Throughout the postoperative period no complications were observed. The patient was discharged from the hospital in a satisfactory condition on the 6th day.
This case report demonstrates an unusual complication of cholelithiasis: cholecystoduodenal fistula with the formation of gallstone ileus. Certain attention at pathology is paid to surgical volume in different groups of patients. One-stage elimination of both ileus and cholecystoduodenal fistula with a cholecystectomy is carried out only in stable patients without severe accompanying pathology. In case of pathology described in this report, it is necessary to perform only enterolithotomy preferably by invasive technique and only in the delayed period depending on the condition of the patient the surgeon should decide on implementation of the second stage – cholecystectomy and elimination of cholecystoduodenal fistula.

Keywords: chronic calculous cholecystitis, cholecystoduodenal fistula, obstructive ileus, gallstone ileus
p. 112-116 of the original issue
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Address for correspondence:
220035, Respublika Belarus,
g. Minsk, ul. Krasnoarmeyskaya, d. 10,
GU "Respublikanskiy klinicheskiy meditsinskiy tsentr".
Upravleniya delami Prezidenta Respubliki Belarus, khirurgicheskoe otdelenie statsionara,
tel. office: +375 017 226-05-36,
e-mail: yurydoc75@gmail.com,
Slobodin Yuriy Valerevich
Information about the authors:
Slabadzin Y.V. PhD, a head of the surgical unit of the in-patient department of SE "The Republican Clinical Medical Centre". The Administration of the President of the Republic of Belarus.
Nikitina L.I. A head of the radiology diagnostics unit of SE "The Republican Clinical Medical Centre". The Administration of the President of the Republic of Belarus.
Paklak-Volsky I.I. A surgeon of the surgical unit of the in-patient department of SE "The Republican Clinical Medical Centre". The Administration of the President of the Republic of Belarus.
Gnipel S.V. A physician of the radiology diagnostics unit of SE "The Republican Clinical Medical Centre". The Administration of the President of the Republic of Belarus.
Rudenkov M.P. A surgeon of the surgical unit of the in-patient department of SE "The Republican Clinical Medical Centre". The Administration of the President of the Republic of Belarus.
Pribushena I.I. A surgeon of the surgical unit of the in-patient department of SE "The Republican Clinical Medical Centre". The Administration of the President of the Republic of Belarus.
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