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Safra Taşı İleusu Değerlendirmesinde Radyolojik Görüntülemenin Klinik Faydası

Year 2019, Volume: 21 Issue: 3, 353 - 358, 31.12.2019
https://doi.org/10.24938/kutfd.590975

Abstract

Amaç: Safra taşı
ileusu
kolelitiazisin nadir bir komplikasyonudur.
Tekrarlayan kolesistit atakları sonucu gelişen kolesistoduodenal fistül yolu
ile safra kesesi taşının intestinal sisteme geçmesi sonucunda oluşur.
Çalışmamızın amacı merkezimizde safra taşı ileusu tanısı alan hastaların
görüntüleme bulgularını sunmaktır.

Gereç ve Yöntemler: Aralık 2016-
Ocak 2019 tarihleri arasında hastanemiz radyoloji birimine başvuran hastalardan
ultrasonografi tetkikinde safra kesesi taşı öyküsü olan hastaların dosyaları
retrospektif olarak incelendi. Bu hastalardan safra taşı ileusu tanısı alan
hastalar tespit edildi. Hastaların hastaneye geliş şikayetleri, yaşları,
cinsiyetleri, eşlik eden hastalıkları ve radyolojik görüntüleme bulguları ile
fistül lokalizasyonu, taşın boyutu, obstrüksiyon seviyeleri değerlendirildi.

Bulgular: Bilinen safra
taşı öyküsü olan 342’si (%35.7) erkek, 616’sı (%64.3) kadın toplam 958 hastadan
safra taşı ileusu tanısı alan 5 hasta tespit edildi. Hastaların 3’ü kadın (yaş
ortalaması 76.67±13.05/ yıl), 2’si erkek (yaş ortalaması 59±1.41 /yıl) idi. Hastaların
direkt grafilerinde ileus bulguları mevcuttu. Yapılan ultrasonografi tetkikinde
tüm hastalarda safra kesesi net olarak vizüalize edilemedi. Değerlendirilebilen
barsak segmentlerinde ileusu düşündürecek çap artışı tespit edildi. İleus
nedenine yönelik yapılan bilgisayarlı tomografide hastaların hepsinde
intrahepatik safra yollarında hava, kolesistoduedonal fistül, barsak lümeninde
taşlar ve bu seviye proksimalinde ileus ile uyumlu görünüm izlendi. Taşların
boyutları ortalama 26.2±16.3 mm (16-55 mm) idi.

Sonuç: Safra taşı ileusu intestinal obstrüksiyonun
nadir nedenlerinden biri olmakla birlikte intestinal obstrüksiyon bulguları ile
acile başvuran ileri yaş ve
kolelitiazis
öyküsü olan hastalarda safra taşı ileusu mutlaka akla gelmelidir.

References

  • 1. Doko M, Zovak M, Kopljar M, Glavan E, Ljubicic N, Hochstadter H. Comparison of surgical treatments of gallstone ileus: preliminary report. World J Surg. 2003;27(4):400-4.
  • 2. Courvoisier L. Case studies and statistics of pathology and surgery of the bile ducts. FCW Vogel 1890. Surg Clin North Am. 1982;62:247.
  • 3. Rigler LG, Borman C, Noble JF. Gallstone obstruction: pathogenesis and roentgen manifestations. J Amer Med Assoc. 1941;117(21):1753-9.
  • 4. Clavien PA, Richon J, Burgan S, Rohner A. Gallstone ileus. Brıt J Surg. 1990;77(7):737-42.
  • 5. Rodriguez‐Sanjuán J, Casado F, Fernandez M, Morales D, Naranjo A. Cholecystectomy and fistula closure versus enterolthotomy alone in gallstone ileus.Brıt J Surg.1997;84(5):634-7.
  • 6. Kasahara Y, Umemura H, Shiraha S, Kuyama T, Sakata K, Kubota H. Gallstone ileus: review of 112 patients in the Japanese literature. Am J Surg. 1980;140(3):437-40.
  • 7. Reisner RM, Cohen JR. Gallstone ileus: a review of 1001 reported cases. Am J Surgeon. 1994;60(6):441-6.
  • 8. Elamyal R, Kapala A, Zegarski W. Obstruction of the small intestine by a large gallstone. Kuwaıt Med J. 2002;34(4):306-7.
  • 9. Lassandro F, Gagliardi N, Scuderi M, Pinto A, Gatta G, Mazzeo R. Gallstone ileus analysis of radiological findings in 27 patients. Eur J Radiol. 2004;50(1):23-9.
  • 10. Daly S, Galloway F. Gallbladder and extrahepatic biliary system. Principles of Surgery. New York. McGraw-Hill Book Co, 1999:1437-66.
  • 11. Martínez RD, Daroca JJ, Escrig SJ, Paiva CG, Alcalde SM, Salvador SJ. Gallstone ileus: management options and results on a series of 40 patients. Rev Esp Enferm Dig. 2009;101(2):117-24.
  • 12. Yamada T, Alpers D, Owyang C. Textbook of gastroenterology. Diseases of the biliary tree-biliary fistula. NY. JB Lippincott Company, 2013.
  • 13. Khaira H, Thomas D. Gallstone emesis and ileus caused by common hepatic duct‐duodenal fistula. Brit J Surg. 1994;81(5):723.
  • 14. Ploneda-Valencia CF, Sainz-Escárrega VH, Gallo-Morales M, Navarro-Muñiz E, Bautista-López CA, Valenzuela-Pérez JA et al. Karewsky syndrome: a case report and review of the literature. I Int J Surg Case Reports. 2015;12:143-5. Doi: 10.1016/j.ijscr.2015.05.034.
  • 15. Nuño-Guzmán CM, Marín-Contreras ME, Figueroa-Sánchez M, Corona JL. Gallstone ileus, clinical presentation, diagnostic and treatment approach. World J Gastrointest Surg. 2016;8(1):65.
  • 16. Lafitte S, Hanafi R, Browet F. Transrectal endoscopic treatment of gallstone ileus. J Vısc Surg. 2019;156(3):269-270.

CLINICAL UTILITY OF RADIOLOGICAL IMAGING IN THE EVALUATION OF GALLSTONE ILEUS

Year 2019, Volume: 21 Issue: 3, 353 - 358, 31.12.2019
https://doi.org/10.24938/kutfd.590975

Abstract

Objective: Gallstone ileus is a rare complication
of cholelithiasis. It occurs as a result of the passage of bile stones into
intestinal system via bilioenteric fistulae, which are formed by recurrent
attacks of cholecystitis, and obstruction of the intestinal lumen. The
objective of our study was to discuss the imaging findings of gallstone ileus
among patients diagnosed at our center.

Material and Methods: Among patients that admitted to our
hospital’s radiology department between December 2016 and January 2019, the
medical records of those with a history of gall bladder stone detected on
ultrasonography were retrospectively evaluated. Among those, cases of gallstone
ileus were identified. Admission complaints, age, sex, comorbidities,
radiological imaging findings, fistula localization, stone size, and
obstruction level were recorded and analyzed.

Results: Among 958 patients with bile stones, 342
(35.7%) were male and 616 (64.3%) were female. Gallstone ileus was identified
in five patients. Three of them were female (mean age
76.67± 13.05 years) and 2
were male
(mean
age 59
±1.41 years). Ileus signs were detected on plain radiograms for
all patients. The gallbladders were not clearly visualized by ultrasonography
in any of patients with gallstone ileus. A diameter increase suggestive of
ileus was detected in visualizable intestinal segments. Computed tomography to
identify the cause of ileus revealed air in the bile ducts, cholecystoduodenal
fistula, stones in intestinal lumen, and an appearance consistent with ileus
proximal to that segment. The mean size of the stones was 26.20±16.3 mm (16-55
mm).

Conclusion:
Although gallstone ileus is a rare cause of
intestinal obstruction, it should be definitely remembered in the differential
diagnosis in patients with advanced age and a history of cholelithiasis who
present to the emergency department.

References

  • 1. Doko M, Zovak M, Kopljar M, Glavan E, Ljubicic N, Hochstadter H. Comparison of surgical treatments of gallstone ileus: preliminary report. World J Surg. 2003;27(4):400-4.
  • 2. Courvoisier L. Case studies and statistics of pathology and surgery of the bile ducts. FCW Vogel 1890. Surg Clin North Am. 1982;62:247.
  • 3. Rigler LG, Borman C, Noble JF. Gallstone obstruction: pathogenesis and roentgen manifestations. J Amer Med Assoc. 1941;117(21):1753-9.
  • 4. Clavien PA, Richon J, Burgan S, Rohner A. Gallstone ileus. Brıt J Surg. 1990;77(7):737-42.
  • 5. Rodriguez‐Sanjuán J, Casado F, Fernandez M, Morales D, Naranjo A. Cholecystectomy and fistula closure versus enterolthotomy alone in gallstone ileus.Brıt J Surg.1997;84(5):634-7.
  • 6. Kasahara Y, Umemura H, Shiraha S, Kuyama T, Sakata K, Kubota H. Gallstone ileus: review of 112 patients in the Japanese literature. Am J Surg. 1980;140(3):437-40.
  • 7. Reisner RM, Cohen JR. Gallstone ileus: a review of 1001 reported cases. Am J Surgeon. 1994;60(6):441-6.
  • 8. Elamyal R, Kapala A, Zegarski W. Obstruction of the small intestine by a large gallstone. Kuwaıt Med J. 2002;34(4):306-7.
  • 9. Lassandro F, Gagliardi N, Scuderi M, Pinto A, Gatta G, Mazzeo R. Gallstone ileus analysis of radiological findings in 27 patients. Eur J Radiol. 2004;50(1):23-9.
  • 10. Daly S, Galloway F. Gallbladder and extrahepatic biliary system. Principles of Surgery. New York. McGraw-Hill Book Co, 1999:1437-66.
  • 11. Martínez RD, Daroca JJ, Escrig SJ, Paiva CG, Alcalde SM, Salvador SJ. Gallstone ileus: management options and results on a series of 40 patients. Rev Esp Enferm Dig. 2009;101(2):117-24.
  • 12. Yamada T, Alpers D, Owyang C. Textbook of gastroenterology. Diseases of the biliary tree-biliary fistula. NY. JB Lippincott Company, 2013.
  • 13. Khaira H, Thomas D. Gallstone emesis and ileus caused by common hepatic duct‐duodenal fistula. Brit J Surg. 1994;81(5):723.
  • 14. Ploneda-Valencia CF, Sainz-Escárrega VH, Gallo-Morales M, Navarro-Muñiz E, Bautista-López CA, Valenzuela-Pérez JA et al. Karewsky syndrome: a case report and review of the literature. I Int J Surg Case Reports. 2015;12:143-5. Doi: 10.1016/j.ijscr.2015.05.034.
  • 15. Nuño-Guzmán CM, Marín-Contreras ME, Figueroa-Sánchez M, Corona JL. Gallstone ileus, clinical presentation, diagnostic and treatment approach. World J Gastrointest Surg. 2016;8(1):65.
  • 16. Lafitte S, Hanafi R, Browet F. Transrectal endoscopic treatment of gallstone ileus. J Vısc Surg. 2019;156(3):269-270.
There are 16 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section ART
Authors

Adnan Özdemir This is me

Yunus Yılmazsoy 0000-0001-7293-2059

Serdar Arslan 0000-0001-7984-4326

Faruk Pehlivanlı 0000-0002-2175-8756

Publication Date December 31, 2019
Submission Date July 11, 2019
Published in Issue Year 2019 Volume: 21 Issue: 3

Cite

APA Özdemir, A., Yılmazsoy, Y., Arslan, S., Pehlivanlı, F. (2019). CLINICAL UTILITY OF RADIOLOGICAL IMAGING IN THE EVALUATION OF GALLSTONE ILEUS. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi, 21(3), 353-358. https://doi.org/10.24938/kutfd.590975
AMA Özdemir A, Yılmazsoy Y, Arslan S, Pehlivanlı F. CLINICAL UTILITY OF RADIOLOGICAL IMAGING IN THE EVALUATION OF GALLSTONE ILEUS. Kırıkkale Uni Med J. December 2019;21(3):353-358. doi:10.24938/kutfd.590975
Chicago Özdemir, Adnan, Yunus Yılmazsoy, Serdar Arslan, and Faruk Pehlivanlı. “CLINICAL UTILITY OF RADIOLOGICAL IMAGING IN THE EVALUATION OF GALLSTONE ILEUS”. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 21, no. 3 (December 2019): 353-58. https://doi.org/10.24938/kutfd.590975.
EndNote Özdemir A, Yılmazsoy Y, Arslan S, Pehlivanlı F (December 1, 2019) CLINICAL UTILITY OF RADIOLOGICAL IMAGING IN THE EVALUATION OF GALLSTONE ILEUS. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 21 3 353–358.
IEEE A. Özdemir, Y. Yılmazsoy, S. Arslan, and F. Pehlivanlı, “CLINICAL UTILITY OF RADIOLOGICAL IMAGING IN THE EVALUATION OF GALLSTONE ILEUS”, Kırıkkale Uni Med J, vol. 21, no. 3, pp. 353–358, 2019, doi: 10.24938/kutfd.590975.
ISNAD Özdemir, Adnan et al. “CLINICAL UTILITY OF RADIOLOGICAL IMAGING IN THE EVALUATION OF GALLSTONE ILEUS”. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 21/3 (December 2019), 353-358. https://doi.org/10.24938/kutfd.590975.
JAMA Özdemir A, Yılmazsoy Y, Arslan S, Pehlivanlı F. CLINICAL UTILITY OF RADIOLOGICAL IMAGING IN THE EVALUATION OF GALLSTONE ILEUS. Kırıkkale Uni Med J. 2019;21:353–358.
MLA Özdemir, Adnan et al. “CLINICAL UTILITY OF RADIOLOGICAL IMAGING IN THE EVALUATION OF GALLSTONE ILEUS”. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi, vol. 21, no. 3, 2019, pp. 353-8, doi:10.24938/kutfd.590975.
Vancouver Özdemir A, Yılmazsoy Y, Arslan S, Pehlivanlı F. CLINICAL UTILITY OF RADIOLOGICAL IMAGING IN THE EVALUATION OF GALLSTONE ILEUS. Kırıkkale Uni Med J. 2019;21(3):353-8.

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