Complete Radiological Findings in Gallstone Ileus
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چکیده
CC This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons. org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Figure 1. Abdominal radiograph and barium meal. (A) Abdominal radiograph demonstrating the 'Rigler Triad' of dilated small bowel loops in the left upper quadrant (arrow), linear lucencies in the right upper quadrant, corresponding to the anatomic location of the liver, suggesting pneumobilia (arrowhead) as well as a partly calcified ovoid density in the left lower quadrant (curved arrow). (B) Spot image from a barium meal examination demonstrating abnormal early filling of the gallbladder (curved arrow) from a fistulous tract originating at the junction of the first and second parts of the duodenum. A 79 year old female causcasian patient with a background history of type II diabetes mellitus, hypertension and hyper-cholesterolaemia, presented with a 1 day history of bilateral flank and lower abdominal pain and a few episodes of vomiting. Of note, there was no history of constipation or obstipation. Clinical exam on presentation showed no localizing abdominal signs. The patient was also found to be dehydrated and hyperglycaemic. A plain radiograph of the abdomen was performed (Fig. 1A). This demonstrated the 'Rigler Triad' of dilated small bowel loops in the left upper quadrant (arrow), linear lucencies in the right upper quadrant, corresponding to the anatomic location of the liver, suggesting pneumobilia (arrowhead) as well as a partly cal-cified ovoid density in the left lower quadrant (curved arrow). If these are present, it is considered to be sufficient for diagnosis in the correct clinical scenario.
منابع مشابه
[Gallstone ileus: a rare cause of intestinal obstruction].
Gallstone ileus is an uncommon complication of cholelithiasis, with a high morbidity and mortality rate, usually related to the delayed diagnosis of intestinal obstruction. Diagnosing gallstone ileus needs a high index of suspicion. A case of a gallstone ileus is reported. The clinical presentation, radiological features, intra-operative findings, operative procedure and literature review are p...
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