Biliary ileus: consideration of 23 cases
Borea, B.; Casagrande, M.; Spivach, A.
Annali Italiani di Chirurgia 52(4): 417-432
1980
ISSN/ISBN: 0003-469X PMID: 7224428 Document Number: 162975
Of 686 mechanical intestinal occlusions, 23 cases of biliary ileus are discussed. The mean age of the patients was 72.3 yr. The prevailing sex was female with a ratio of 4:1 over the male. All the cases were admitted with a general diagnosis of intestinal occlusion. Only 4 cases presented clinical elements leading to an exact etiologic diagnosis. X-rays showed the presence of hydroaero levels in 100% of the cases, pneumobilia in 13% and calculus in an anomalous region in 4.35%. An opaque enema given in 5 cases revealed the presence of a region in 4.35%. An opaque enema given in 5 cases revealed the presence of a cholecystocolic fistulous passage in 4.35%, a plier-like image in 4.35% and in 13.04% it appeared negative. The calculus was most frequently lodged in the terminal ileus, followed by the sigma and the Treitz. In 18 cases surgery was limited to enterotomy with removal of the calculus, in 4 cases there was a spontaneous resolution of the picture and in only 1 case enterotomy was performed accompanied by biliary drainage and closure of the biliodigestive fistula. A mortality of 8.7% and a morbidity of 26.09%, caused mainly by broncopulmonary complications, was shown.