A CASE REPORT ON BILIARY ILEUS AS A RARE TRIGGER FOR INTESTINAL OBSTRUCTION

Introduction: Biliary ileus is a rare mechanical obstruction. It is caused by the entrapment of biliary macro-lithiasis in a portion of the digestive tract arising from a bilio-digestive fistula. We report a clinical case to better understand this disease, as well as to illustrate the diagnostic and therapeutic pitfalls, and to determine the current therapeutic strategy.

Observation: We report the case of a 71-year-old patient who was admitted to the emergency department for an occlusive syndrome consisting of cessation of matter and gas, vomiting and abdominal pain for 48 hours. An injected abdomino-pelvic CT scan showed a biliary ileus with 3 jejunal and ileal enclave lithiases giving a upper intestinal obstruction. There were no signs of acute cholecystitis. Management was straightforward with enterolithotomy alone after correction of hydroelectrolyte disorders. Postoperative management was straightforward.

Conclusion: Biliary ileus is a rare surgical condition. The high mortality rate in the management of this pathology means that enterolithotomy remains the least invasive and most recommended method.