Acute Intestinal Obstruction Due To Gallstone Ileus [abdome Agudo Por Obstrução Por Ileobiliar]

Objective: Small bowel obstruction (SBO) due to gallstones (gallstone ileus) is an uncommon complication of cholelithiasis, for which there is no defined surgical procedure. The objective of this study was to perform a systematic review of the history, available image exams and clinical approach to the diagnosis and treatment of gallstone ileus. Method: We conducted a retrospective study in a university hospital including all cases of SBO treated over a period of 23 years. According to the surgical treatment, the patients were divided into two groups: (1) enterolithotomy with posterior cholecystectomy (two-stage surgery); and (2) enterolithotomy, cholecystectomy and fistula closure (one-stage surgery). Results: Twelve patients were included in the study, including 11 females (91,6%), with a mean age of 72.2 years. All patients presented associated diseases, mainly arterial hypertension (75%). All except one patient had multiple SBO symptoms. Gallstone ileus diagnosis was made before laparotomy in six patients (50%). There were eight patients in group 1 and four in group 2, and the morbidity was, respectively, 33.3% and 8.3%. Overall mortality was 16.6% (one patient in each group). Conclusion: Gallstone ileus should be suspected in the elderly with SBO symptoms. Early diagnosis can reduce post-operative complications. Treatment is urgent laparotomy and the surgical approach must be individualized for each case. The majority of patients in this study were treated with enterolithotomy, with cholecystectomy being performed later in two symptomatic patients.404275280Martin, F., Intestinal obstruction due to gall-stones: With report of three successful cases (1912) Ann Surg., 55 (5), pp. 725-743Reisner, R.M., Cohen, J.R., Gallstone ileus: A review of 1001 reported cases (1994) Am Surg., 60 (6), pp. 441-446Lobo, D.N., Jobling, J.C., Balfour, T.W., Gallstone ileus: Diagnostic pittfalls and therapeutic successes (2000) J Clin Gastroenterol., 30 (1), pp. 72-76Hayes, N., Saha, S., Recurrent gallstone Ileus (2012) Clin Med Res., 10 (4), pp. 236-239Carrascosa, M.F., Riego-Martín, M.D., Salcines Caviedes, J.R., González Gutiérrez, P., Gallstone ileus (2012) BMJ Case Rep., , Feb 21;2012Rojas-Rojas, D.J., Martínez-Ordaz, J.L., Romero-Hernández, T., Biliary ileus: 10-years experience (2012) Cir Cir., 80 (3), pp. 228-232Tucker, A., Garstin, I., A peculiar cause of bowel obstruction (2013) Int J Surg Case Rep., 4 (5), pp. 473-476Halabi, W.J., Kang, C.Y., Ketana, N.K., Lafaro, K.J., Nguyen, V.K., Stamos, M.J., Surgery for gallstone ileus: A nationwide comparison of trends and outcomes (2013) Ann Surg., , jan 4 [Epub ahead of print]Pronio, A., Piroli, S., Caporilli, D., Ciamberlano, B., Coluzzi, M., Castellucci, G., Recurrent gallstone ileus: Case report and literature review (2013) G Chir., 34 (1-2), pp. 35-37McHado, M.A.C., Jukemura, J., Volpe, P., Abdo, E.E., Penteado, S., Bacchella, T., Fístulas biliares internas: Estudo de 13 casos e revisão da literatura (1995) Hos Clin Fac Med S Paulo., 50 (1), pp. 45-48Ayantunde, A.A., Agrawal, A., Gallstone Ileus: Diagnosis and management (2007) World J Surg., 31 (6), pp. 1292-1297Ravikumar, R., Williams, J.G., The operative management of gallstone ileus (2010) Ann R Coll Surg Engl., 92 (4), pp. 279-281Day, E.A., Marks, C., Gallstone ileus: Review of literature and presentation of thirty-four new cases (1975) Am J Surg., 129 (5), pp. 552-558Deitz, D.M., Standage, B.A., Pinson, C.W., McConnell, D.B., Krippaehne, W.W., Improving the outcome in gallstone ileus (1986) Am J Surg., 151 (5), pp. 572-576Bouveret, L., Stenose du pylore, adherent a la vesicule calculeuse (1896) Rev Med., 16, pp. 1-16Gajendran, M., Muniraj, T., Gelrud, A., A challenging case of gastric outlet obstruction (Bouveret's syndrome): A case report (2011) J Med Case Rep., 5, p. 497Costil, V., Jullès, M.C., Zins, M., Loriau, J., Bouveretś syndrome. An unusual localization of gallstone ileus (2012) J Visc Surg., 149 (4), pp. e284-e286Kasahara, Y., Umemura, H., Shiraha, S., Kuyama, T., Sakata, K., Kubota, H., Gallstone ileus. Review of 112 patients in the Japanese literature (1980) Am J Surg., 140 (3), pp. 437-440van Hillo, M., van der Vliet, J.A., Wiggers, T., Obertop, H., Terpstra, O.T., Greep, J.M., Gallstone obstruction of the intestine: An analysis of ten patients and a review of the literature (1987) Surgery., 101 (3), pp. 273-276Nuño-Guzmán, C.M., Arróniz-Jáuregui, J., Moreno-Pérez, P.A., Chávez-Solís, E.A., Esparza-Arias, N., Hernández-González, C.I., Gallstone ileus: One-stage surgery in a patient with intermittent obstruction (2010) World J Gastrointest Surg., 2 (5), pp. 172-176Clavien, P.A., Richon, J., Burgan, S., Rohner, A., Gallstone ileus (1990) Br J Surg., 77 (7), pp. 737-742Murphy, K.P., Kearney, D.E., Mc Laughlin, P.D., Maher, M.M., Complete radiological findings in gallstone ileus (2012) J Neurogastroenterol Motil., 18 (4), pp. 448-449Huang, S.T., Huang, M.Y., Gallstone ileus: A diagnostic challenge by plain radiography (2013) Emerg Med J., 30 (5), p. 370Lasson, A., Lorén, I., Nilsson, A., Nirhov, N., Nilsson, P., Ultrasonography in gallstone ileus: A diagnostic challenge (1995) Eur J Surg., 161 (4), pp. 259-263Mishin, I., Ghidirim, G., Zastavnitsky, G., Non-operative treatment for gall-stone ileus-a case report (2011) Pol Przegl Chir., 83 (4), pp. 223-226Conzo, G., Mauriello, C., Gambardella, C., Napolitano, S., Cavallo, F., Tartaglia, E., Gallstone ileus: One-stage surgery in an elderly patient: One-stage surgery in gallstone ileus (2013) Int J Surg Case Rep., 4 (3), pp. 316-318Mallipeddi, M.K., Pappas, T.N., Shapiro, M.L., Scarborough, J.E., Gallstone ileus: Revisiting surgical outcomes using National Surgical Quality Improvement Program data (2013) J Surg Res., , May 31. [Epub ahead of print]Beriner, S.D., Burson, L.C., One-stage repair for cholecyst-duodenal fistula and gallstone ileus (1965) Arch Surg., 90, pp. 313-316Jones, R., Broman, D., Hawkins, R., Corless, D., Twice recurrent gallstone ileus: A case report (2012) J Med Case Rep., 6 (1), p. 362Paiva-Coronel, G., Martínez-Ramos, D., Cosa-Rodríguez, R., Salvador-Sanchis, J.L., Íleo biliar. Abordaje asistido por laparoscopia (2010) Cir Esp., 87 (4), pp. 255-25

Obstructive gastric pseudotumor caused by cytomegalovirus in an aids patient: a case report and review of surgical treatment

Cytomegalovirus (CMV) is a common opportunistic pathogen in patients with HIV. It is also a major cause of gastrointestinal ulcers in patients with acquired immunodeficiency syndrome (AIDS). CMV pseudotumor in the stomach is a rare cause of digestive tract obstruction. In this study we report a male patient infected with HIV in 2002. In 2014 he evolved C3 stage AIDS with pre-pyloric gastric ulcer which provoked deformity and pseudotumoral aspect of the gastric outlet. Endoscopic biopsy confirmed CMV infection. He underwent Roux-en-Y gastroenteroanastomosis with good recovery. CMV infection should be considered as an agent in gastric lesions in HIV-infected patients. Roux-en-Y gastroenteroanastomosis is a surgical option for this group of patients, allowing improvements in quality of life and decreasing risks of perioperative complications.Cytomegalovirus (CMV) is a common opportunistic pathogen in patients with HIV. It is also a major cause of gastrointestinal ulcers in patients with acquired immunodeficiency syndrome (AIDS). CMV pseudotumor in the stomach is a rare cause of digestive trac16536541sem informaçãosem informaçã