INTRODUCTION Cases of gallstone ileus account for 1% to 4% of all instances of mechanical bowel obstruction. The majority of obstructing gallstones are located in the terminal ileum. Less than 10% of impacted gallstones are located in the duodenum. A gastric outlet obstruction secondary to a gallstone ileus is known as Bouveret syndrome. Gallstones usually enter the bowel through a biliary ente...

AIM To retrospectively establish the diagnostic criteria of gallstone ileus on CT, and to prospectively apply these criteria to determine the diagnostic accuracy of CT to confirm or exclude gallstone ileus in patients who presented with acute small bowel obstruction (SBO). Another purpose was to ascertain whether the size of ectopic gallstones would affect treatment strategy. METHODS Fourteen...

Although a cholesterol supersaturation of gallbladder bile has been identified as the underlying pathophysiologic defect, the molecular pathomechanism of gallstone formation in humans remains poorly understood. A deficiency of the apical sodium bile acid transporter (ASBT) and ileal lipid binding protein (ILBP) in the small intestine may result in bile acid loss into the colon and might promote...

E690 CMAJ, October 1, 2013, 185(14) © 2013 Canadian Medical Association or its licensors A90-year-old man was admitted with acute-onset, pressing retrosternal pain and diffuse abdominal discomfort. Electrocardiography and cardiac troponin levels ruled out an acute coronary syndrome. Plain radiography of the abdomen (Figure 1A) showed multiple air–fluid levels and air in the biliary tree (pneumo...

Gallstone ileus is a complication of cholelithiasis resulting from a fistula between the gallbladder and the gastrointestinal tract. If sufficiently large, a gallstone may lodge at the narrowest part of the gastrointestinal tract, usually the terminal ileum, and present with small bowel obstruction. Here the authors present the unusual case of an 82-year-old man who developed symptoms and signs...

The diagnosis of gallstone ileus is occasionally challenging due to the variability of its presentation. We herein present a very rare case of gallstone ileus inducing obstructive jaundice at the afferent loop of Roux-en-Y hepaticojejunostomy after 10 years of bile duct cancer surgery. We describe the case of a 74-year-old Korean woman with obstructive jaundice, treated conservatively. She show...

BACKGROUND Gallstones represent a prevalent and costly health problem. The changing epidemiology and the emerging non-surgical interventions for gallstone disease necessitate the definition of target populations for future therapies. This study aimed to define patterns of gallstone composition and identify demographic predictors of gallstone composition in a large sample of symptomatic gallston...

Cholesterol gallstone formation is a response to interactions between multiple genes and environmental stimuli. To determine the subset of cholesterol gallstone susceptibility (Lith) genes possessed by strains CAST/Ei (susceptible) and 129S1/SvImJ (resistant), we conducted quantitative trait locus (QTL) analyses of an intercross between these strains. Parental strains and F(1) mice of both gend...

Cholelithiasis occurs in 10% of the population, most commonly caused by gallstone formation from bile salt cholesterol hypersaturation. Common presentations include cholecystitis and pancreatitis, yet these two gallstone diseases rarely seem to happen simultaneously. Gallstone pancreatitis occurs when gallstones escape from the gallbladder and become lodged within the common bile duct causing b...

The results allow proposing a novel hypothesis and concept of cholesterol gallstone pathogenesis in man: cholestanol may be responsible for the cholesterol supersaturation of gallbladder bile, aseptic inflammation of the gallbladder mucus and consecutive hypersecretion of glycoprotein mucin, gallbladder hypomotility as well as for the heterogenic nucleation process and precipitation of choleste...