Deutsche medizinische Wochenschrift (1946) · 2010
[Ultrasonographic diagnosis of a biliary-digestive fistula with gallstone ileus].
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Rauh P, Neye H, Ensberg D, Bönicke P, Georgiew E, Rickes S
Аннотация
HISTORY AND CLINICAL FINDINGS: A 72-year-old woman was admitted to the hospital with upper abdominal pain, nausea, vomiting, and obstipation.
INVESTIGATIONS: Percutaneous ultrasound found aerobilia, a biliary-digestive fistula, and an ileus with gallstones within the small bowel. The findings were confirmed at computed tomography.
TREATMENT AND COURSE: A gallstone ileus on the basis of a biliary-digestive fistula was diagnosed. The patient was treated by surgery and with antibiotics.
CONCLUSION: This case report demonstrates that percutaneous ultrasonography should be used as the first imaging procedure in the diagnosis of acute abdominal pain. This procedure makes it possible to detect a gallstone ileus. It is important also to define various intestinal structures accurately.
INVESTIGATIONS: Percutaneous ultrasound found aerobilia, a biliary-digestive fistula, and an ileus with gallstones within the small bowel. The findings were confirmed at computed tomography.
TREATMENT AND COURSE: A gallstone ileus on the basis of a biliary-digestive fistula was diagnosed. The patient was treated by surgery and with antibiotics.
CONCLUSION: This case report demonstrates that percutaneous ultrasonography should be used as the first imaging procedure in the diagnosis of acute abdominal pain. This procedure makes it possible to detect a gallstone ileus. It is important also to define various intestinal structures accurately.