mAetiology: Prolonged history of gall stone with fistulation between the gall bladder and duodenum or transverse colon.
mPathology: The stone usually impacted at the site of absorbed vitello-intestinal duct (the narrowest part) ® simple intestinal obstruction.
Rarely stone ulcerating into the colon may stay for long time and attain large size to become impacted in the rectum.
mCl.Picture: Simple intestinal obstruction. But the diagnosis is usually delayed as the patient is accustomed to recurrent attacks of biliary colic in the form of abd. pain, vomiting.
m Diagnosis: Plain x-ray ® Gas in the gall bladder
m Treatment: Surgical removal of the stone.
SOURCE: DR. AYMAN SALEM'S BOOK
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