부산대학교 도서관

Once the duodenal stump was closed, the place-holding catheter was removed and the cystic duct stump was oversewn as well. On multi-phase computerized tomography, I Rigler's triad i - which is specific to gallstone ileus - was present: small bowel obstruction (or gastric outlet obstruction in this case), pneumobilia, and an ectopic gallstone.[1] In addition to a 6 cm gallstone seen in the first portion of the duodenum (D1), a fistulous tract from the duodenum to a contracted gallbladder was also visible (Fig. After takedown of the fistula, gallstone removal, and cholecystectomy, the tissue quality of the remaining D1 was too poor to entertain primary repair or even duodenojejunostomy. [Extracted from the article]