Case Report
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Nov 27, 2016; 8(11): 755-760
Published online Nov 27, 2016. doi: 10.4240/wjgs.v8.i11.755
Gallstone ileus associated with impaction at Meckel’s diverticulum: Case report and literature review
Harveen K Lamba, Yiwen Shi, Ajita Prabhu
Harveen K Lamba, Yiwen Shi, Ajita Prabhu, Department of General Surgery, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH 44106, United States
Author contributions: Lamba HK and Prabhu A performed the surgery, and managed post-operative care of patient; Prabhu A collected the patient’s clinical data; Lamba HK and Shi Y designed the case report, analyzed the clinical data and wrote the paper.
Institutional review board statement: The study was reviewed and approved by the University Hospitals Case Medical Center Institutional Review Board.
Informed consent statement: Verbal informed consent was obtained from the patient in question.
Conflict-of-interest statement: The authors of this manuscript have no conflict of interests, financial or otherwise, to report.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ajita Prabhu, MD, FACS, Department of General Surgery, University Hospitals Case Medical Center, Case Western Reserve University, 11100 Euclid Avenue, Cleveland, OH 44106, United States. hkl12@case.edu
Telephone: +1-216-8443027 Fax: +1-216-8448201
Received: January 20, 2016
Peer-review started: January 20, 2016
First decision: March 1, 2016
Revised: April 11, 2016
Accepted: June 1, 2016
Article in press: June 3, 2016
Published online: November 27, 2016
Abstract

Gallstone ileus due to erosion of one or more gallstones into the gastrointestinal tract is an uncommon cause of small bowel obstruction. The site of impaction is usually distal ileum, and less commonly the jejunum, colon, duodenum, or stomach. We report a rare case of gallstone ileus with impaction at the proximal small bowel and at a Meckel’s diverticulum (MD) in a 64-year-old woman managed with laparoscopic converted to open small bowel resections. Patient was discharged home in stable condition and remained asymptomatic at 6-mo follow up. We review the current literature on surgical approaches to MD and gallstone ileus. Diverticulectomy or segmental resection is preferred for complicated MD. For gallstone ileus, simple enterolithotomy or segmental resection are the most the most favored especially in older co-morbid patients due to lower mortality rates and the rarity of recurrent gallstone ileus. In addition, laparoscopy has been increasingly reported as a safe approach to manage gallstone ileus.

Keywords: Gallstone ileus, Meckel’s diverticulum, Small bowel obstruction, Laparoscopy, Cholecystoenteric fistula, Laparoscopy

Core tip: Gallstone ileus is an uncommon cause of small bowel obstruction in the population at large but is responsible for up to a quarter of mechanical bowel obstructions in the elderly in the United States. We report a rare case of gallstone ileus with impaction at the jejunum and at a Meckel’s diverticulum in a 64-year-old female managed by laparoscopic converted to open segmental bowel resections. We review current literature comparing surgical procedures for Meckel’s diverticulum and gallstone ileus.