J Korean Surg Soc.  2007 Mar;72(3):254-257.

Gallstone Perforation of the Ileum Found during an Operation for CBD Malignancy

• Cho B
• Choi Y
• Shin D

Abstract

Gallstone is a common disease with a prevalence of about 10%, but biliary ileus is a rare entity with a frequency of about 1% for all the symptomatic patients. We are reporting on a case of perforated terminal ileum that was due to gallstone, and this was without any associated intestinal obstruction or bilioenteric fistula. A 76 year old man presented with a history of jaundice and dark colored urine for a 3-month duration with no clinical features of intestinal obstruction. There was no past history of biliary tract disease. The abdominal radiograph demonstrated no biliary stones or classical findings of gallstone ileus, but there was a suspicion of cholangiocarcinoma. Laparotomy was performed. A perforation of terminal ileum was identified in the mesenteric border of the terminal ileum and adjacent to ileocecal valve, and it was wrapped by omentum. A small 1.5 cm sized stone was impacted in the mesentery at the site of the perforation. The perforation site was closed. Cholecystectomy and proximal common bile duct resection with Roux-en-Y choledochojejunostomy was then performed.

Keyword

Gallstone ileus; Cholangiocarcinoma; Perforation of terminal ileum

MeSH Terms

Aged
Biliary Tract Diseases
Cholangiocarcinoma
Cholecystectomy
Choledochostomy
Common Bile Duct
Fistula
Gallstones*
Humans
Ileocecal Valve
Ileum*
Ileus
Intestinal Obstruction
Jaundice
Laparotomy
Mesentery
Omentum
Prevalence