Published online Nov 27, 2016. doi: 10.4240/wjgs.v8.i11.755
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
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.
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.