Gallstone ileus. INTRODUCTIONGallstone ileus is an important, though infrequent, cause of mechanical bowel obstruction, affecting older adult patients who often have other significant medical conditions. It is caused by impaction of a gallstone in the ileum after being passed through a biliary- enteric fistula. The diagnosis is often delayed since symptoms may be intermittent and investigations fail to identify the cause of the obstruction. The mainstay of treatment is removal of the obstructing stone after resuscitating the patient. Gallstone ileus continues to be associated with relatively high rates of morbidity and mortality. Other causes of intestinal obstruction are discussed elsewhere. Female and older patients are disproportionally affected . PATHOGENESISThe usual means of gallstone entry into the bowel is through a biliary enteric fistula, which complicates 2 to 3 percent of all cases of cholelithiasis with associated episodes of cholecystitis. Sixty percent are cholecystoduodenal fistulas, but cholecystocolonic and cholecystogastric fistulas can also result in gallstone ileus .
An association between the Mirizzi syndrome and the presence of a cholecystoenteric fistula has been suggested because when a stone is impacted in the cystic duct it can result in narrowing of the common hepatic duct, which can lead to a cholecystenteric fistula thus providing an exit route for gallstones . People who have had pancreatic cancer removed surgically may have better survival time without disease progression if they are treated with gemcitabine (Gemzar) for 6. Offers vitamins and minerals, herbal supplements, health and beauty items, and weight loss products. Provides nutrition recommendations, resources, and company profile. Offers massage, facial, body wrap, acupuncture and other day spa services. Includes rates, specials and hours. Cartolina dalla vacanza. Design by Gio&Vi Mitopositano com - News Manciano - Saturnia - indexvecchia - index cogn - Hotels of the world - Agriturismi Vacanze.
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