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Ultrasonography in gallstone ileus: a diagnostic challenge.

OBJECTIVE
To describe our experience with ultrasound diagnosis of gallstone ileus in six cases, and to assess the impact of our findings in the light of published reports.


DESIGN
Open study.


SETTING
Teaching hospital, Sweden.


SUBJECTS
Six patients with gallstone ileus.


INTERVENTION
Abdominal ultrasound examination. MAIN OUTCOME MEASURES--Correlation with plain abdominal films and with findings at laarotomy.


RESULTS
In all six cases ultrasound gave a precise diagnosis of gallstone ileus, together with the exact location of the gallstone, whereas plain films usually indicated only intestinal obstruction of unknown cause. There was not mortality and only one postoperative complication, and all patients were alive and well at the time they were last seen. These results compare well with those of other reported series.


CONCLUSION
The high morbidity and mortality of gallstone ileus may be reduced if ultrasonography is used in cases of undiagnosed abdominal pain, particularly in elderly patients with protracted symptoms.