Gallstone ileus: dilemma in the management

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Girish D. Bakhshi *
Rajesh G. Chincholkar
Jasmine R. Agarwal
Madhukar R. Gupta
Prachiti S. Gokhe
Amogh R. Nadkarni
(*) Corresponding Author:
Girish D. Bakhshi | gdbakhshi@yahoo.com

Abstract

Gallstone ileus is a mechanical intestinal obstruction caused due to impaction of a large gallstone within the bowel. The ideal treatment of gallstone ileus remains controversial, with the main dilemma being between a one-stage and a two-stage surgical procedure. A 69-year old male patient presented with gallstone ileus. A one-stage procedure with enterolithotomy and primary closure of duodenal fistula was done. His immediate postoperative recovery was uneventful, but after 3 weeks of surgery, he developed respiratory complications and expired of multi-organ failure. In gallstone ileus, patient presents with symptoms of intestinal obstruction. Enterolithotomy alone remains the most common operative method, but the definitive surgical management is still under research. An intraoperative dilemma between a one-stage or twostage surgery is difficult to resolve in absence of clear guidelines. Hence, more studies are required to come to a consensus in deciding its definitive management.

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Author Biographies

Girish D. Bakhshi, Department of General Surgery, Grant Government Medical College & Sir JJ Group of Hospitals, Mumbai

Associate Professor and Head of Unit, Department of General Surgery

Rajesh G. Chincholkar, Department of General Surgery, Grant Government Medical College & Sir JJ Group of Hospitals, Mumbai

Assistant Professor, Department of General Surgery

Jasmine R. Agarwal, Department of General Surgery, Grant Government Medical College & Sir JJ Group of Hospitals, Mumbai

Chief Resident, Department of General Surgery

Madhukar R. Gupta, Department of General Surgery, Grant Government Medical College & Sir JJ Group of Hospitals, Mumbai

Chief Resident, Department of General Surgery

Prachiti S. Gokhe, Department of General Surgery, Grant Government Medical College & Sir JJ Group of Hospitals, Mumbai

Junior Resident, Department of General Surgery

Amogh R. Nadkarni, Department of General Surgery, Grant Government Medical College & Sir JJ Group of Hospitals, Mumbai

MBBS student