Year: 2025
Type: article
Study design: Case Report
Abstract: Gallstone ileus is a rare but serious complication in patients with cholelithiasis, resulting in an increased risk of mortality, highlighting the importance of timely diagnosis and management. Excess weight loss after bariatric surgery is associated with more pronounced symptomatic gallstone disease. We present a 44-year-old female with a previous vertical sleeve gastrectomy who presented with progressively worsening mechanical small bowel obstruction. Computed tomography showed cholelithiasis, and magnetic resonance cholangiopancreatography identified extravasation of contrast from the gallbladder to the duodenum. Laparotomy with enterolithotomy revealed a large gallstone completely obstructing the proximal jejunum. In patients with prior bariatric surgery presenting with symptoms of small bowel obstruction, the diagnosis of gallstone ileus requires a high index of suspicion. While the optimal procedure is heavily debated, one-stage procedures should be reserved for patients who are clinically optimized. Gallstone ileus is a rare but serious diagnosis not isolated to the comorbid elderly. Further studies are needed to assess the incidence of gallstone ileus after bariatric surgery.
Source: Cureus
DOI: 10.7759/cureus.90148
Authors: Michael C Wilkinson, Esther Wu
Institutions: Loma Linda University, Loma Linda University Health Care
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4413468226