EURORAD ESR

Case 14141

An uncommon case of gallstone ileus

Author(s)
Sofia Dutra, David Silva, Zélia Rego, Pedro Cordeiro

Hospital do Divino Espírito Santo de Ponta Delgada, Hospital do Divino Espírito Santo de Ponta Delgada, Radiologia; Rua Grotinha 9500-370 Ponta Delgada, Portugal; Email:sofiardutra@hotmail.com
 
Patient
female, 90 year(s)
 
 
  • Figure 1
    Erect abdominal radiograph

    Dilated small bowel loops with air-fluid levels.

     
    Area of Interest: Abdomen; Imaging Technique: Plain radiographic studies; Procedure: Imaging sequences; Special Focus: Dilatation;
     
     
  • Figure 2
    Axial post contrast CT
     

    Intrahepatic bile duct dilatation and marked gastric distension

     
    Area of Interest: Liver; Imaging Technique: CT; Procedure: Computer Applications-Detection, diagnosis; Special Focus: Dilatation;

    Collapsed gallbladder with air within the lumen, wall thickening and adjacent fat densification (yellow arrow) and a cholecystoduodenal fistula (red arrow).

     
    Area of Interest: Biliary Tract / Gallbladder; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Fistula;

    Gallstone in the distal choledochal duct.

     
    Area of Interest: Biliary Tract / Gallbladder; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Calcifications / Calculi;

    Large gallstone in the lumen of the distal ileum (3.5cm) (yellow arrow).

     
    Area of Interest: Biliary Tract / Gallbladder; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Calcifications / Calculi;
     
     
  • Figure 3
    Figure 3
     

    Reconstructed coronal CT image: Two gallstone in the distal choledochal duct (yellow arrow) and a large gallstone in the distal ileum (red arrow).

     
    Area of Interest: Biliary Tract / Gallbladder; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Obstruction / Occlusion;

    Reconstructed coronal CT image: Cholecystoduodenal fistula (yellow arrow) and extra-hepatic bile ducts dilatation (red arrows). There is also a marked gastric distension.

     
    Area of Interest: Biliary Tract / Gallbladder; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Fistula;
     
     
Dilated small bowel loops with air-fluid levels.
 
Intrahepatic bile duct dilatation and marked gastric distension
 
Collapsed gallbladder with air within the lumen, wall thickening and adjacent fat densification (yellow arrow) and a cholecystoduodenal fistula (red arrow).
 
Gallstone in the distal choledochal duct.
 
Large gallstone in the lumen of the distal ileum (3.5cm) (yellow arrow).
 
Reconstructed coronal CT image: Two gallstone in the distal choledochal duct (yellow arrow) and a large gallstone in the distal ileum (red arrow).
 
Reconstructed coronal CT image: Cholecystoduodenal fistula (yellow arrow) and extra-hepatic bile ducts dilatation (red arrows). There is also a marked gastric distension.
 
 
 
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