Fístula Colecistoduodenal en el Adulto Mayor

Abstract

Gallstone ileus is a rare cause of intestinal obstruction that affects older adults, which is caused by impaction of one or more gallstones in the small intestine after passing through a biliary-enteric fistula. Very rarely the biliary stones can enter the intestine through a fistulous communication between the common bile and digestive tract. The term gallstone ileus was first coined by Bartholin in 1654. The diagnosis is often delayed because symptoms are often intermittent and treatment is surgical or endoscopic removal of biliary stones. The most common site of impaction of the calculus is the terminal ileum and the ileocecal valve; and the least common are the jejunum, the ligament of Treitz and stomach, and duodenum and colon are rare sites. the case of a female patient 64 years old, which is transferred to the General Hospital Puyo with a clinical picture characterized by abdominal distension of 3 days of evolution accompanied by vomiting more diffuse abdominal pain occurs. Abdominal ultrasound liver steatosis reported more cholelithiasis; abdominal pelvic scan showed two gallstone 21 and 18 millimeters housed in duodenum and ileum respectively and marked dilation in intestinal and colon hazas. Laboratory findings showed amylase and lipase figures three times its normal value, confirming acute biliary pancreatitis. The management of acute pancreatitis was expectantly while Ileobiliar was surgically resolved. His post surgical evolution was satisfactory, being discharged at 6 days after surgery.