Jejunum-Biliary Intestinal Obstruction - Case Report by Miguel Prestes Nácul in BJSTR

Jejunum-Biliary Intestinal Obstruction - Case Report by Miguel Prestes Nácul in BJSTR

Abstract

Introduction: Intestinal obstruction by a gallstone (biliary jejunum) is an uncommon and potentially serious omplication of chronin cholecystitis. Ileum gallstone represents 25% of non-strangulation obstructions in the small bowel causing 1% to 3% of all obstruction surgeries. Biliary ileum located in the proximal jejunum is a rare condition and the treatment post minimum invasive technic tends to be the best therapeutic option when available.

Material and Method: case report of 87 years old female diagnosed with duodenum biliary post acute cholecystitis.

Results: After frustrated attempt of gallstone removal by upper digestive endoscopy, the gallstone migrated to proximal jejunum. After observation expecting for the gallstone to evolve through the small bowel, surgery was opted due to the obstrucion maintenance. The patient was submitted for a videolaparoscopy to remove the 4 cm gallstone by enterotomy and enterorrhaphy. No complications were presented after surgery.

Conclusion: The option for a videolaparcopy approach showed effective, even more in a elderly patient in a matter of fact of decrease morbidity and mortality related to the abdominal wall.

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