GI Radiology


Case  36 :  
 

60 year old male with acute abdomen. CT was performed. What is the diagnosis?

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Imaging Diagnosis

Gall Stone Ileus


Discussion

Gallstone ileus is a rare complication of recurrent gallstone cholecystitis. The classic radiographic triad of small bowel obstruction, pneumobilia and ectopic gallstone on abdominal plain radiograph is best seen with CT imaging.

The gallstone enters the gastrointestinal tract through a fistula between a gangrenous gallbladder and duodenum or other parts of the gastrointestinal tract. The most common site of impaction of gallstones is in the distal ileum, followed by jejunum and stomach. Computed tomography (CT) invariably demonstrates a fistulous communication, intraluminal gallstone in the small bowel, pneumobilia and any other co-existing pathology contributing to the impaction of the gallstone.


References:
Shahat AH, Obaideen AM, Pandey UC. Images : Gallstone Ileus. Indian J Radiol Imaging [serial online] 2002 [cited 2007 Aug 24];12:349-351. Available from: http://www.ijri.org/text.asp?2002/12/3/349/28479