Cholelithiasis Intestinal Obstruction

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Abstract

The obstructive form of small bowel obstruction is a result of obstruction of the intestinal lumen from the inside or outside, which leads to the disruption of chyme passage while maintaining normal blood circulation in the mesentery. Gallstones, foreign bodies, parasites, tumors, cicatricial stenoses, infiltrates of the intestinal walls can cause an internal block and lead to obstruction.

Mechanical obstruction caused by gallstones is rare but it is a serious complication of cholelithiasis. Typically, gallstone intestinal obstruction is preceded by the formation of a large stone, followed by the migration of the latter through the cholecystoeneral (-duodenal) fistula.

Due to the low prevalence of this complication, there are no large-scale randomized clinical studies in the literature. Therefore, the analysis of individual clinical cases, based on which a rational plan for therapeutic and diagnostic tactics of patient management is formed.

The article presents a clinical case of gallstone obstructive intestinal obstruction due to the formation of a biliodigestive fistula. This form of intestinal obstruction is a complication of gallstone disease and is quite rare. The comorbidity of patients and the atypical clinical picture of the disease complicate diagnosis of treatment of this pathology. This requires a more detailed set of diagnostic measures, and individual approach to the choice of method and scope of surgical treatment for each specific case.

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About the authors

Galina A. Shishkina

North-Western State Medical University named after I.I. Mechnikov

Email: Galina.Shishkina@szgmu.ru
ORCID iD: 0009-0008-6875-039X
SPIN-code: 6765-1266

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Saint Petersburg

Aleksej V. Petryashev

North-Western State Medical University named after I.I. Mechnikov

Email: Aleksei.Petryashev@szgmu.ru
ORCID iD: 0009-0008-3919-5470
SPIN-code: 1724-2067

MD, Cand. Sci. (Medicine)

Russian Federation, Saint Petersburg

Rustem E. Topuzov

North-Western State Medical University named after I.I. Mechnikov

Email: rustem_topuzov@yahoo.com
ORCID iD: 0000-0001-8168-6187
SPIN-code: 5904-9165

MD, Cand. Sci. (Medicine), Assistant Professor

Russian Federation, Saint Petersburg

Vyacheslav K. Balashov

North-Western State Medical University named after I.I. Mechnikov

Email: Vyacheslav.Balashov@szgmu.ru
ORCID iD: 0009-0004-5575-9871
SPIN-code: 9479-9052

MD, Cand. Sci. (Medicine), Assistant Professor

Russian Federation, Saint Petersburg

Zamira A. Khalukhoeva

North-Western State Medical University named after I.I. Mechnikov

Author for correspondence.
Email: zamihaluhoeva@mail.ru
ORCID iD: 0009-0000-2047-4324

MD

Russian Federation, Saint Petersburg

Anastasiia V. Runova

North-Western State Medical University named after I.I. Mechnikov

Email: doc@arunova.ru
ORCID iD: 0009-0009-3755-6137

MD

Russian Federation, Saint Petersburg

Ivan V. Kruglov

North-Western State Medical University named after I.I. Mechnikov

Email: kv-71312@mail.ru
ORCID iD: 0009-0008-6202-6499

MD

Russian Federation, Saint Petersburg

Anna A. Kuznetsova

North-Western State Medical University named after I.I. Mechnikov

Email: Anika8820@mail.ru
ORCID iD: 0000-0002-6901-9004
SPIN-code: 9077-0209

MD

Russian Federation, Saint Petersburg

References

  1. Bohan KL. Сholelithic intestinal obstruction. Grekov’s bulletin of surgery. 1996;155(4):110–112. (In Russ.)
  2. Dobrovolsky SR, Ivanov MP, Nagay IV. Iintestinal gallstone obstruction. Journal Surgery named after N.I. Pirogov. 2004;3:51–55. (In Russ.)
  3. Dibirov MD, Fedorov VP, Martirosian NK, et al. Clinical course, diagnosis and treatment of cholelithic intestinal obstruction. Journal Surgery named after N.I. Pirogov. 2007;5:17–21. EDN: LETCDZ
  4. Davidov MI, Nikonova OE. Experience in the diagnosis and treatment of gallstone intestinal obstruction. Medical Almanac. 2015;(3(38)):230–233. EDN: UNCLDF
  5. Korovin AYa, Trifanov NA, Bazlov SB, Turkin DV. Biliary ileus. Modern problems of science and education. 2019;(2):155. EDN: ZERARN doi: 10.17513/spno.28737
  6. Davydkin VI, Karpushkina PI, Pigachev AV. Small intestinal obstruction as a rare complication of gallstone disease. Grekov’s bulletin of surgery. 2019;178(6):59–62. EDN: YZODOK doi: 10.24884/0042-4625-2019-178-6-59-62
  7. Mamchich VI, Bondarenko ND, Chaika MA. New in the problem of gallstone intestinal obstruction. Annals of HPB surgery. 2020;25(1):62–68. EDN: OKRNFL doi: 10.16931/1995-5464.2020162-68

Supplementary files

Supplementary Files
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2. Fig. 1. Review radiography of abdominal cavity organs.

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3. Fig. 2. X-ray monitoring of barium sulfate passage 6 hours after ingestion.

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4. Fig. 3. Intestinum tenue impregnated with concretion.

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5. Fig. 4. The extracted concretion.

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