TECNICA QUIRURGICA DE LAPAROTOMIA EXPLORADORA PDF

Background: Gallstone ileus GI represents a rare cause of mechanical intestinal occlusion, which is caused by the impaction of a gallstones at the gastrointestinal tract, being most frequently the terminal ileum; its etiology is due to the passage of a calculum through a biliary-enteric fistula. Due to its low incidence, diagnostic suspicion and adequate initial surgical treatment are essential for an adequate clinical evolution. Objective: A bibliographic review on the current surgical management of GI was carried out and exemplified by the presentation a clinical case. Clinical case: year-old male with bowel obstruction, upon undergoing a CT scan, a gallstone at the level of distal ileum is displayed, therefore, an exploratory laparotomy ex lap is performed with enterotomy and extraction of the calculus. The patient bestowed adequate postoperative clinical evolution, and the presence of a cholecystoduodenal fistula is documented by an upper endoscopy. Discussion: GI represents an uncommon pathology, however, there is discrepancy in the literature regarding the initial surgical management, especially in whether or not a biliary procedure should be associated with emergency enterolithotomy.

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Background: Gallstone ileus GI represents a rare cause of mechanical intestinal occlusion, which is caused by the impaction of a gallstones at the gastrointestinal tract, being most frequently the terminal ileum; its etiology is due to the passage of a calculum through a biliary-enteric fistula.

Due to its low incidence, diagnostic suspicion and adequate initial surgical treatment are essential for an adequate clinical evolution. Objective: A bibliographic review on the current surgical management of GI was carried out and exemplified by the presentation a clinical case.

Clinical case: year-old male with bowel obstruction, upon undergoing a CT scan, a gallstone at the level of distal ileum is displayed, therefore, an exploratory laparotomy ex lap is performed with enterotomy and extraction of the calculus.

The patient bestowed adequate postoperative clinical evolution, and the presence of a cholecystoduodenal fistula is documented by an upper endoscopy. Discussion: GI represents an uncommon pathology, however, there is discrepancy in the literature regarding the initial surgical management, especially in whether or not a biliary procedure should be associated with emergency enterolithotomy.

Conclusion: GI is associated with complications secondary to diagnostic delay and its late surgical resolution, although the initial treatment is aimed at resolving the intestinal obstruction through enterotomy and gallstone extraction, there is controversy regarding the preferred time for cholecystectomy and repair of biliary-enteric fistula, being the two-stage surgery the surgical procedure of choice, especially in patients with a high risk of complications.

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Full-text links Cite Favorites. Abstract in English , Spanish. Similar articles [Enterolithotomy and early cholecystectomy, an application of damage control surgery for patients with gallstone ileus]. Cir Cir. Epub May PMID: Spanish. Gallstone ileus: case report and literature review. Dai XZ, et al. World J Gastroenterol. Aguilar-Espinosa F, et al. Epub Jan PMID: Review. Spaziani E, et al.

G Chir. PMID: Italian. Gallstone Ileus Post-cholecystectomy. Acta Chir Belg. PMID: Show more similar articles See all similar articles.

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[Gallstone Ileus, Surgical Management Review]

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