000			02261cam a2200157 4500
001			NMDX7026
008			120401t2014 xxu||||| |||| 00| 0 eng d
100			_aGandamihardja, T.A.
240			_aBMJ Case Reports
245			_aRecurrent gallstone ileus: beware of the faceted stone
260			_c2014
500			_aNMUH Staff Publications
520			_a<span style="font-size: 10pt;">A 73-year-old man with <span class="highlight" style="font-family: arial, helvetica, clean, sans-serif;">gallstone</span> disease was admitted with right upper quadrant abdominal pain. He was treated for cholecystitis with intravenous antibiotics. Two days later, he reported of new onset left iliac fossa pain, with tenderness and guarding. An abdominal X-ray demonstrated small bowel obstruction, a CT scan demonstrated an impacted <span class="highlight" style="font-family: arial, helvetica, clean, sans-serif;">gallstone</span> within the proximal ileum. He was treated for a <span class="highlight" style="font-family: arial, helvetica, clean, sans-serif;">gallstone</span> ileum and underwent an uncomplicated laparotomy, small bowel enterotomy and removal of a faceted <span class="highlight" style="font-family: arial, helvetica, clean, sans-serif;">gallstone</span>. Three months later, the patient re-presented with generalised abdominal pain, guarding and rebound tenderness. Small bowel obstruction was again demonstrated with an impacted <span class="highlight" style="font-family: arial, helvetica, clean, sans-serif;">gallstone</span> within the distal ileum seen on CT scan. A second laparotomy revealed two further faceted <span class="highlight" style="font-family: arial, helvetica, clean, sans-serif;">gallstones</span>, which were removed through an enterotomy. The densely adherent gallbladder to the duodenum precluded a surgical repair of the cholecystoduodenal fistula. He made an uneventful recovery and was subsequently discharged home.</span>
856			_uhttps://www.ncbi.nlm.nih.gov/pubmed/25391822
856			_uhttp://casereports.bmj.com/content/2014/bcr-2014-205795.long
999			_c76037 _d76037