CT is also useful for evaluating the complications of acute cholecystitis, such as emphysematous cholecystitis, gangrenous cholecystitis, haemorrhage, and gallstone ileus
. CT plays a critical role in patient management by suggesting the correct diagnosis based on characteristic imaging findings, identifying the complications especially in critically ill patients and reduce the morbidity and mortality by immediate percutaneous cholecystostomy or cholecystectomy.
is a rare cause (1%-4% of cases) of mechanical small bowel obstruction.
Complications of gallstones: the Mirizzi syndrome, gallstone ileus
, gallstone pancreatitis, complications of "lost" gallstones.
(a) without gallstone ileus
and (b) with gallstone ileus
ReeceSmith, "Gallstone ileus
without a gallbladder," Annals of the Royal College of Surgeons of England, vol.
Dietz DM, Standage BA, Pinson CW et al: In proving outcome in gallstone ileus
. Am J Suge 1986; 151: 572-76.
Probably owing to low calcium content in these stones, they are rarely picked up in plain X-rays [9, 10]; on the other hand findings like pneumobilia on the same could suggest gallstone ileus
that must be supported with findings of biliary abnormalities on ultrasonography .
A large number of incidental gastrointestinal findings can be observed during abdominal MDCT exam; they can be divided into benign, indeterminate, and worrisome ; even if the most frequent are benign ones, there are several conditions such as abdominal hernias, giant colon diverticulum, GIST, intestinal pneumatosis, colon ischemia, cold intussusception, gallstone ileus
, and foreign bodies that represent a clinical medical emergency, and because of that a strait clinical and surgical attention may be needed (Table 1).
Bezoar-induced obstruction should be distinguished from gallstone ileus
because bezoars produce the same sonographic image as ectopic lithiasis.
Symptomatic gallstone disease may lead to complications including acute cholecystitis, chronic cholecystitis, empyema of gallbladder, mucocele, choledocholithiasis with or without cholangitis, gallstone pancreatitis, gallstone ileus
, and gallbladder carcinoma4.
* Gallstone ileus
is a rare complication of recurrent gallstones.