Hasan YERLİ, Tuğbahan YILMAZ, Ali ER, Arzu KOBAK

Safra Taşı İleusu: Düz Radyografi ve Bilgisayarlı Tomografi Bulguları

Safra taşı ileusu kolelitiyazisin nadir karşılaşılan bir komplikasyonudur. Bu olgu sunumunda kolesistoduodenal fistül sonrasında safra taşına bağlı ileus gelişen bir olgunun direkt grafi ve bilgisayarlı tomografi bulguları sunulmuştur. Direkt grafide pnömobilia ve ince bağırsaklarda dilatasyon saptandı. Bilgisayarlı tomografi incelemesinde safra kesesinde, intrahepatik safra yollarında ve koledokta gaz, ileumda 5x3 cm. boyutlarında taş, taşın proksimalindeki ince bağırsak segmentlerinde dilatasyon ve kolesistoduodenal fistül saptandı. Yapılan enterotomi ile taş çıkarıldı. İnce barsak ve fistül onarıldı, kolesistektomi gerçekleştirildi. Bu olgu sunumu, safra taşı ileusunda, biliyer-enterik fistül düzeyi ile taş düzeyinin saptanmasında bilgisayarlı tomografinin tanısal duyarlılığını vurgulamaktadır

Gallstone Ileus: Plain X-Ray and Ct Findings

Gallstone ileus is a rare complication of cholelithiasis. We report a case of gallstone ileus due to cholecystoduodenal fistula with the corresponding plain x-rays and computerized tomography findings. The plain x-ray film showed pneumobilia and small bowel dilatation. Computerized tomography demonstrated pneumobilia involving the common hepatic and common bile ducts, cholecystoduodenal fistula, a 5x3 cm calcified stone in the ileum and small bowel dilatation. At operation, a stone obstructing the ileum was found and it was removed via an enterotomy. Furthermore a cholecystoduodenal fistula was detected and it was primarily repaired after performance of a cholecystectomy. The aim of this report is to accentuate the sensitivity of computerized tomography examination in the determination of the location of the bilioenteric fistula and the stone in gallstone ileus

Keywords:

gallstone ileus, pneumobilia, cholecystoenteric fistula, intestinal obstruction,

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