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BMJ Case Reports 2015; doi:10.1136/bcr-2015-209654
  • CASE REPORT

Gallstone ileus of the sigmoid colon: an extremely rare cause of large bowel obstruction detected by multiplanar CT

  1. Sanjay Gandhi
  1. North Bristol Trust, Southmead Hospital, Bristol, UK
  1. Correspondence to Dr Tarryn Carlsson, tarrync{at}gmail.com
  • Accepted 1 December 2015
  • Published 18 December 2015

Summary

Gallstone ileus of the sigmoid colon is an important, though extremely rare, cause of large bowel obstruction. The gallstone often enters the large bowel through a fistula formation between the gallbladder and colon, and impacts at a point of narrowing, causing large bowel obstruction. We describe the case of an 80-year-old woman who presented with features of bowel obstruction. Multiplanar abdominal CT demonstrated a cholecystocolonic fistula in exquisite detail. The scan also showed obstruction of the colon due to a large gallstone impacted just proximal to a stricture in the sigmoid. Owing to inflammatory adhesions and a stricture from extensive diverticular disease, the gallstone could not be retrieved. This frail and elderly woman was treated with a loop colostomy to relieve bowel obstruction. The patient made an uneventful recovery.

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