Clinical and radiological diagnosis of gallstone ileus: a mini review.
Emerg Radiol. 2018 Apr;25(2):189-196. doi: 10.1007/s10140-017-1568-5. Epub 2017 Nov 16.
Chang L1,2, Chang M3, Chang HM3, Chang AI4, Chang F4,5.
Gallstone ileus is a rare cause of bowel obstruction, which mainly affects the elderly population. The associated mortality is estimated to be up to 30%. The presentation of gallstone ileus is notoriously non-specific, and this often contributes to the delay in diagnosis. The diagnosis of gallstone ileus relies on a radiological approach, and herein we discuss the benefits and drawbacks of the use of different modalities of radiological imaging: plain abdominal films, computed tomography, magnetic resonance imaging, and ultrasound scanning. Based on our case experience and review of the literature, the authors conclude that although an effective first-line tool, plain abdominal films are not adequate for diagnosing gallstone ileus. In fact, the gold standard in an acutely unwell patient is computed tomography.