Jacobs Journal of Clinical Case Reports

Meckel’s gallstone ileus

*Farid Mojtahed
Department Of Radiology, Netherlands

*Corresponding Author:
Farid Mojtahed
Department Of Radiology, Netherlands
Email:F.FaridMojtahedi@mst.nl

Published on: 2016-10-20

Abstract

A 72-year-old male presented in our clinic with jaundice, dark urine, steatorrhea and unexplained weight loss. The patient had a medical history of ischaemic stroke, a melanoma and was known to have cholecystolithiasis. A computed tomography (CT) of the abdomen was performed, which showed aerobillia, distended small bowels and a gallstone impacted in the ileum. At surgery a gallstone was impacted in the ileum, at the neck of a Meckels diverticulum. The stone was removed and the patient had a good recovery. The impaction of a gallstone at the neck of a Meckels diverticulum is rare.

Keywords

Gallstone; Ileus; Computed tomography; Meckels divertiulum

Introduction

An uncommon cause of an ileus is obstruction by a gallstone. Gallstones cause 1-4 % of all mechanical ileus [1]. Of all non-strangulation ileus the gallstone accounts for up to 25% of all cases in patients over 65 years old [2]. This condition occurs when an inflamed gallbladder adheres to an adjacent bowel forming a biliary-enteric fistula. Usually a biliary-duodenal fistula occurs, which can allow gallstones to enter the gastrointestinal tract [3]. In rare cases the gallstone can erode through the gallbladder wall and large intestine wall and cause obstruction [4]. There have even been cases of a gallstone ileus developing after an Endoscopic retrograde cholangiopancreatography (ERCP), where the gallstone escaped the gallbladder through the common bile duct into the duodenum. In most of these cases the gallstone impacts in the terminal ileum [5]. However, we describe a case of a gallstone impacting at the neck of a Meckel’s diverticulum.