銅筋鐵肋的秘密基地

Elderly woman with midabdominal pain and vomiting 

  










Dx: Gallstone ileus, with gastric dilatation and small bowel dilatation
no pneumatosis intestinalis or bowel wall thickening

* Image findings: Rigler's triad
  1) pneumobilia (air in biliary tract): in 2/3 patients
  2) partial or complete bowel obstruction
  3) ectopic gallstone
  4) bowel obstruction is usually seen.
      calcified stone in 1/4-1/5 patients
* stone size>2.5cm may cause mechanical obstruction
* site: ileocecal valve (76%) > dudenum (21%) > sigmoid colon (2%)
* complications: gastric outlet obstruction,  Bouveret's syndrome

# 以上

Reference: AuntMinnie's  http://education.auntminnie.com/QMachine.ASP?UID=1UB0YCCL&PageId=1&Sess=5643427