Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 16, 2023; 11(17): 4159-4167
Published online Jun 16, 2023. doi: 10.12998/wjcc.v11.i17.4159
Endoscopic and surgical treatment of jejunal gallstone ileus caused by cholecystoduodenal fistula: A case report
Wen-Juan Fan, Mei Liu, Xin-Xia Feng
Wen-Juan Fan, Mei Liu, Xin-Xia Feng, Department of Gastroenterology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
Author contributions: Fan WJ reviewed the literature and contributed to manuscript drafting and imaging data interpretation; Liu M performed the endoscopy and analyzed the imaging findings and endoscopic images; Feng XX was responsible for revising the manuscript for important intellectual content; all authors provided approval of the final version for submission and publication.
Supported by The National Natural Science Foundation of China, No. 82100568.
Informed consent statement: Informed written consent was obtained from family members of the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicting interests to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xin-Xia Feng, MD, PhD, Associate Professor, Department of Gastroenterology, Tong-ji Hospital, Tong-ji Medical College, Hua-zhong University of Science and Technology, No. 1037 Luo-yu Road, Wu-han 430030, Hu-bei Province, China. fengxinxia@163.com
Received: March 22, 2023
Peer-review started: March 22, 2023
First decision: April 11, 2023
Accepted: May 9, 2023
Article in press: May 9, 2023
Published online: June 16, 2023
Core Tip

Core Tip: Gallstone ileus is a rare complication of gallstone disease that is common in elderly patients, with high mortality. In this case of gallstone ileus, abdominal imaging showed classical Rigler’s triad including ectopic gallstone, intestinal obstruction, and pneumobilia. We performed propulsive enteroscopy and laser lithotripsy twice but failed to remove the stone. Finally, the patient underwent the one-stage procedure including laparoscopic duodenoplasty (fistula closure), cholecystectomy, and enterolithotomy. However, the patient presented with several complications including acute renal failure and finally died. Early surgical intervention is the main treatment for gallstone ileus. For elderly patients with significant comorbidities, enterolithotomy alone is advised.