What is Gallstone Ileus?
is a condition which is characterized by bowel obstruction due to gall stones. Gallstones which are relatively bigger and have is at least 2.5 cm in diameter.
It accounts for 1-4% of all cases of intestinal obstruction. It is mostly seen in people above ages of 65. It accounts to at least 25% of all cases of bowel obstructions in people above 65. It is more common in women than men. Women are 3 to 16 times more likely to be affected.
The site of impaction of gall stones is most prominent in the distal ileum (the last part of the small intestine), next only to the jejunum ( the middle section of the small intestine) and the stomach.
What is the mechanism of Gall Bladder ileus?
A gall bladder which is infested with relatively larger sized stones and has turned gangrenous is usually present. It establishes an abnormal connection or fistula between itself and the duodenum and other parts of the small intestine. This facilitates the passage of the stone. The stone reaches the small intestine through a fistula between the bile duct and the gastrointestinal duct. Stones which are less than 2.5 cm may pass through the intestine without causing any obstruction. The discussed condition arises when the gallstone lodges itself in the first part of the small intestine and causes a gastrointestinal obstruction.
It is a disease which affects mostly the old and frail. Patients who have undergone abnormal narrowing of the intestine due to tuberculosis or other disease is also more prone to be affected by this condition.
Symptoms of the condition
- Severe abdominal pain. The pain is not localized and is intermittent appearing in the form of colicky spasms.
- Severe vomiting. Vomiting may appear only after the onset of abdominal pain.
- Bloating and abdominal distention.
- Defecation or passing stools and flatulence may be present initially but may stop later on as the condition progress.
- Tender abdomen.
- Signs of dehydration.
Treatment of Gall Bladder Ileus
- An intravenous administration of fluids is essential to restore hydration.
- Endoscopic intervention will enable to decompress the stomach and reduce vomiting.
- Surgical removal of the gallstones obstructing the alimentary passage is extremely essential. It is also important to look for other gall stones nearby. It is possible that other gallstones are lodged nearby.
- Surgical removal of the gall bladder (Cholecystectomy) can be done simultaneously with the removal of stones or later.