A Krasnoyarsk woman had part of her intestine removed due to a stone that migrated from the gallbladder

In the Krasnoyarsk regional hospital, the patient had part of her intestine removed due to a rare complication of cholelithiasis. This was reported by the hospital's press service.

A 56-year-old woman presented to the emergency department with left abdominal pain, high fever, and repeated vomiting. The symptoms persisted for three days, although the patient had not previously been bothered by anything.

Doctors suspected acute pancreatitis, but pancreatic enzymes were normal, and inflammatory blood parameters were significantly elevated. An ultrasound showed only a small amount of fluid in the abdominal cavity. To clarify the diagnosis, a multislice computed tomography scan with contrast was performed. The result was unexpected: a foreign body was found in the upper parts of the small intestine, and the gallbladder was not visualized. The patient denied that she had ever undergone abdominal surgery.

Doctors assumed that a stone from the gallbladder migrated into the intestines, forming a fistula. The diagnosis was confirmed by FGDS: a hole with a diameter of up to three centimeters was found in the duodenum, from which bile flowed. By that time the stone had already moved lower down the intestine.

Surgeons planned to remove the stone laparoscopically, but during the operation they found peritonitis and partial necrosis of the small intestine. I had to do a cavity intervention – remove a section of the intestine along with the stone. The postoperative period was complicated by purulent inflammation, and repeated surgery was required. On the 14th day the patient was discharged in satisfactory condition.

The gallbladder was not removed – it was completely replaced by scar tissue. Six months later, the gallbladder was not visualized on control tomography, and the fistula closed on its own.

Operating surgeon Pavel Sobolev noted that the migration of stones into the intestines, the formation of a fistula and intestinal necrosis developed in a patient who had not previously been bothered by anything. Even asymptomatic carriers of gallstones can lead to severe and life-threatening complications. If stones are identified and there are indications for surgery, you should not postpone planned treatment – complications arise suddenly, and their consequences can be irreversible.

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