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Vol. 41. Núm. 8.
Páginas 510-511 (Octubre 2018)
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Vol. 41. Núm. 8.
Páginas 510-511 (Octubre 2018)
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Gallstone ileus secondary to a cholecystocolonic fistula
Ileo biliar secundario a fístula colecistocolónica
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Luisa Roade Tato
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luisaroadet@gmail.com

Corresponding author.
, Meritxell Ventura Cots, Mar Riveiro-Barciela
Liver Unit, Internal Medicine Department, Hospital Universitari Vall d’Hebron, Barcelona, Spain
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A 78-year-old man exhibited repeated episodes of vomiting, diffuse abdominal pain and constipation for 10 days. One year previously, he had suffered from biliary colic but cholecystectomy was not performed because of high surgical risk. Physical examination showed a mass on the left side of the abdomen and increased bowel sounds. The blood count showed light leukocytosis and normal metabolic profile. An abdominal radiography showed Rigler's triad (Fig. 1, Image A): pneumobilia (yellow arrow), small-bowel dilatation, and two ectopic gallstones in the sigmoid colon (red arrows). Computerized tomography confirmed the presence of intra and extrahepatic pneumobilia (Fig. 1, Image B), as consequence of cholecysto-colonic fistula secondary to cholelitiasis. Gallstone ileus is a rare complication of gallstone disease, and in less than 4% of cases the gallstone is located in the sigmoid colon. The diagnosis is not always straightforward and usually depends on radiographic findings, although the classic Rigler??s triad is described in fewer than half of patients1-3. A laparotomy was performed and a right hemicolectomy was necessary because of colonic perforation. The patient underwent successful surgery and no post-operative complications ensued.

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References
[1]
R.M. Reisner, J.R. Cohen.
Gallstone ileus: a review of 1001 reported cases.
Am Surg, 60 (1994), pp. 441-446
[2]
F. Lassandro, N. Gagliardi, M. Scuderi, A. Pinto, G. Gatta, R. Mazzeo.
Gallstone ileus analysis of radiological findings in 27 patients.
Eur J Radiol, 50 (2004), pp. 23-29
[3]
L.G. Rigler, C.N. Borman, J.F. Noble.
Gallstone obstruction: pathogenesis roentgen manifestations.
JAMA, 117 (1941), pp. 1753-1759
Copyright © 2018. Elsevier España, S.L.U.. All rights reserved
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