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Pesce A, Lauro A, Gonella Pacchiotti C, D'Andrea V, Fabbri N, Bertasi M, Feo CV. Like a Rolling (Gall)Stone: Optimal Treatment of Gallstone Obstruction of the Sigmoid Colon. Dig Dis Sci 2024; 69:1593-1601. [PMID: 38466460 PMCID: PMC11098863 DOI: 10.1007/s10620-024-08328-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 01/30/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND Sigmoid gallstone ileus is a rare complication of cholelithiasis, accounting for 1-4% of all cases of large-bowel obstruction. This is a highly morbid, and often fatal, condition due to its challenging diagnosis and late presentation. CASE PRESENTATION We report a case of a 90-year-old woman admitted to Emergency Department with abdominal pain and large-bowel obstruction due to a 6 cm gallstone lodged in a diverticulum of the proximal sigmoid colon as a consequence of a cholecysto-colonic fistula. Colonoscopy was deferred due to gallstone size carrying a high possibility of failure. The patient underwent urgent laparotomy with gallstone removal via colotomy. The cholecystocolonic fistula was left untreated. The post-operative course was uneventful; the patient was discharged on 6th post-operative day. CONCLUSION A multidisciplinary discussion between endoscopists and surgeons is often needed to choose the best therapeutic option, especially in high-risk patients.
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Affiliation(s)
- Antonio Pesce
- Unit of General Surgery, Department of Surgery, "Azienda Unità Sanitaria Locale" of Ferrara, University of Ferrara, Via Valle Oppio, 2, 44023, Lagosanto, FE, Italy.
| | - Augusto Lauro
- Department of Surgery, "Sapienza" University of Rome, V.Le Regina Elena 324, 00161, Rome, Italy
| | - Costanza Gonella Pacchiotti
- Unit of General Surgery, Department of Surgery, "Azienda Unità Sanitaria Locale" of Ferrara, University of Ferrara, Via Valle Oppio, 2, 44023, Lagosanto, FE, Italy
| | - Vito D'Andrea
- Department of Surgery, "Sapienza" University of Rome, V.Le Regina Elena 324, 00161, Rome, Italy
| | - Nicolò Fabbri
- Unit of General Surgery, Department of Surgery, "Azienda Unità Sanitaria Locale" of Ferrara, University of Ferrara, Via Valle Oppio, 2, 44023, Lagosanto, FE, Italy
| | - Mario Bertasi
- Unit of General Surgery, Department of Surgery, "Azienda Unità Sanitaria Locale" of Ferrara, University of Ferrara, Via Valle Oppio, 2, 44023, Lagosanto, FE, Italy
| | - Carlo Vittorio Feo
- Unit of General Surgery, Department of Surgery, "Azienda Unità Sanitaria Locale" of Ferrara, University of Ferrara, Via Valle Oppio, 2, 44023, Lagosanto, FE, Italy
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Knight AW, Wu R, Tennakoon L, Knowlton LM. Cholecystocolonic fistula: an unusual presentation of large bowel obstruction. Trauma Surg Acute Care Open 2024; 9:e001242. [PMID: 38196931 PMCID: PMC10773438 DOI: 10.1136/tsaco-2023-001242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024] Open
Affiliation(s)
- Ariel W Knight
- Department of Surgery, Stanford University, Stanford, California, USA
| | - Ruoxue Wu
- Department of Surgery, Stanford University, Stanford, California, USA
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