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Objective: Small bowel obstruction (SBO) is a common and important surgical emergency. Our aim in this study is to describe the clinical, laboratory, and computed tomography (CT) findings to facilitate the objective identification of SBO patients in need of operative treatment in this patient population., Methods: This retrospective study included 340 patients hospitalized due to a preliminary diagnosis of ileus. Retrieved data of patients included age, gender, comorbidities, previous hospitalization due to ileus, surgical history, physical examination findings, complete blood count and biochemistry test results, and CT findings at admission., Results: The study included 180 (52.9%) male and 160 (47.1%) female patients. Treatment was conservative in 216 patients and surgery in 124 patients. Of the patients included in the study, 36.4% needed surgery. Of the female patients, 38.90% received conservative treatment and 61.30% underwent surgery. Adhesions were the most common cause of obstruction in operated patients (43.50%)., Conclusion: We have found that female gender, vomiting, guarding, rebound, C-reactive protein levels above 75 mg/L, increased bowel diameter, and a transition zone on CT images indicate a strong need for surgery, but a history of previous hospitalization for ileus may show that surgery may not be the best option., (Copyright: © 2024 Permanyer.)

Recurrent gallstone ileus has a recurrence of 2-8.2% with a mortality of 12-20%, secondary to an enteric or cholecystic gallstone. A male patient with a diagnosis of intestinal occlusion secondary to biliary ileus and cholecystoduodenal fistula, performing enterotomy and closure in two planes with drainage placement. Two months after presenting the clinical of intestinal occlusion, medical management began and an abdominal tomography was performed, finding an image suggestive of recurrent gallstone ileus, treated with laparotomy., (Copyright: © 2023 Permanyer.)

Posponer cirugías electivas durante el proceso pandémico de Covid-19 aumentó el riesgo de complicaciones graves de enfermedades benignas. El íleo biliar es una de las raras complicaciones de la colelitiasis (0,3-0,5%). Los episodios recurrentes de colecistitis aguda están involucrados en la fisiopatología. La demostración de la tríada de Rigler en tomografía computarizada es diagnóstica. Para reducir la morbilidad se recomienda la cirugía dos etapas: extirpar el cálculo por enterotomía en la primera operación, cirugía biliar en la segunda operación. El íleo biliar debe estar en el diagnóstico diferencial de las obstrucciones intestinales mecánicas, especialmente en pacientes con antecedentes de ataques de colecistitis durante el proceso pandémico de Covid-19 porque las cirugías electivas se detuvieron., Postponing elective surgeries during the coronavirus disease-19 (COVID-19) pandemic process increased the risk of severe complications of benign diseases. Gallstone ileus is one of the rare complications of cholelithiasis (0.3-0.5%). Recurrent episodes of acute cholecystitis are involved in pathophysiology. Demonstration of Rigler’s triad on computed tomography is diagnostic. To reduce morbidity stepped surgery is recommended: remove the stone by enterotomy at the first operation and biliary surgery at the second operation. Gallstone ileus should be in the differential diagnosis of mechanical intestinal obstructions, especially in patients with a history of cholecystitis attacks during the COVID-19 pandemic process because elective surgeries stopped., (Copyright: © 2021 Permanyer.)

Gallstone ileus is an intestinal obstruction that is secondary to the presence of gallstones in the small intestine. It is a rare complication of cholelithiasis, which represents 1-3% of the causes of intestinal obstruction. The diagnosis is difficult given that the symptoms are nonspecific with intermittent intestinal obstruction, Rigler's triad (pneumobilia, stone and abdominal distention) is pathognomonic. Among the diagnostic aids are abdominal radiography, ultrasound and abdominal tomography. Treatment should be individualized depending on the patient's conditions, with laparotomy with enterotomy being the treatment of choice., (Copyright: © 2021 Permanyer.)

Introduction: Gallstone ileus is a rare cause of mechanical bowel obstruction, generally found in elderly patients who often have other significant medical conditions., Objective: The objective of the study was to determine the prevalence of gallstone ileus and the number of postsurgical complications and outcomes depending on what type of surgical management is performed., Method: Cohort, retrospective, observational, and comparative study was conducted, which included 31 patients undergoing surgery for gallstone ileus. Three groups were integrated according to the type of surgical procedure: Group 1: enterotomy and stone extraction alone,. Group 2: enterotomy and cholecystectomy with fistula closure, and Group 3: bowel resection alone., Results: A total of 31 patients were analyzed. Gallstone ileus represented the 1.44% of all cases of bowel obstruction. Complication rates were similar between three groups. Mortality rate was lower in Group A, especially when compared to Group B, with a statistically significant difference (p < 0.05)., Conclusions: Surgery is the pillar in treatment of gallstone ileus. Enterotomy with stone extraction alone appears to be associated with a lower mortality rate and better outcomes when compared to more extensive techniques., (Copyright: © 2020 Permanyer.)

Background: A gallstone colonic ileus is a very rare condition., Clinical Case: The case is reported of an 87 year-old patient who came to the Emergency Department due to an intestinal obstruction of several days onset, which was caused by a gallstone affected sigmoid colon., Conclusion: Colonic gallstone ileus is a rare disease that usually occurs in older patients due to the passage of large gallstone directly from the gallbladder to colon, through a cholecystocolonic fistula. It has a high morbidity and mortality., (Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.)