Gallstone Ileus

Gallstone Ileus is a topic covered in the 5-Minute Emergency Consult.

To view the entire topic, please or .

Emergency Central is a collection of disease, drug, and test information including 5-Minute Emergency Medicine Consult, Davis’s Drug, McGraw-Hill Medical’s Diagnosaurus®, Pocket Guide to Diagnostic Tests, and MEDLINE Journals created for emergency medicine professionals. Explore these free sample topics:

-- The first section of this topic is shown below --

Basics

Description

  • Mechanical intestinal obstruction secondary to impaction of a gallstone within bowel lumen
  • Stone is usually >2.5 cm
  • 1–3% of all intestinal obstructions
  • Most cases occur in patients >65
  • Female > male (5:1)
  • Mortality 15–18%

Etiology

  • Chronic gallbladder inflammation causes adhesions between gallbladder and adjacent bowel wall
  • Biliary-enteric fistula develops, permitting stone passage into intestine:
    • Duodenum is the most common site of fistula formation, followed by colon
    • Gastric fistulas are possible but rare
  • Site of impaction
    • Terminal ileum most common (54–65%)
      • Narrowest part of small intestine at level of ileocecal valve
    • Jejunum (27%)
    • Duodenum (1–3%)
      • Gastric outlet obstruction caused by duodenal impaction referred to as Bouveret syndrome
  • Large bowel obstruction is rare

-- To view the remaining sections of this topic, please or --

Basics

Description

  • Mechanical intestinal obstruction secondary to impaction of a gallstone within bowel lumen
  • Stone is usually >2.5 cm
  • 1–3% of all intestinal obstructions
  • Most cases occur in patients >65
  • Female > male (5:1)
  • Mortality 15–18%

Etiology

  • Chronic gallbladder inflammation causes adhesions between gallbladder and adjacent bowel wall
  • Biliary-enteric fistula develops, permitting stone passage into intestine:
    • Duodenum is the most common site of fistula formation, followed by colon
    • Gastric fistulas are possible but rare
  • Site of impaction
    • Terminal ileum most common (54–65%)
      • Narrowest part of small intestine at level of ileocecal valve
    • Jejunum (27%)
    • Duodenum (1–3%)
      • Gastric outlet obstruction caused by duodenal impaction referred to as Bouveret syndrome
  • Large bowel obstruction is rare

There's more to see -- the rest of this topic is available only to subscribers.