Value of CT in the diagnosis and management of gallstone ileus

Chih Yung Yu, Chang Chyi Lin, Rong Yaun Shyu, Chung Bao Hsieh, Hurng Sheng Wu, Yeu Sheng Tyan, Jen I. Hwang, Chang Hsien Liou, Wei Chou Chang, Cheng Yu Chen

Research output: Contribution to journalArticle

103 Citations (Scopus)

Abstract

Aim: To retrospectively establish the diagnostic criteria of gallstone ileus on CT, and to prospectively apply these criteria to determine the diagnostic accuracy of CT to confirm or exclude gallstone ileus in patients who presented with acute small bowel obstruction (SBO). Another purpose was to ascertain whether the size of ectopic gallstones would affect treatment strategy. Methods: Fourteen CT scans in cases of proved gallstone ileus were evaluated retrospectively by two radiologists for the presence or absence of previously reported CT findings to establish the diagnostic criteria. These criteria were applied in a prospective contrast enhanced CT study of 165 patients with acute SBO, which included those 14 cases of gallstone ileus. The hard copy images of 165 CT studies were reviewed by a different group of two radiologists but without previous knowledge of the patient's final diagnosis. All CT data were further analyzed to determine the diagnostic accuracy of gallstone ileus when using CT in prospective evaluation of acute SBO. The size of ectopic gallstone on CT was correlated with the clinical course. Results: The diagnostic criteria of gallstone ileus on CT were established retrospectively, which included: (1) SBO; (2) ectopic gallstone; either rim-calcified or total-calcified; (3) abnormal gall bladder with complete air collection, presence of air-fluid level, or fluid accumulation with irregular wall. Prospectively, CT confirmed the diagnosis in 13 cases of gallstone ileus with these three criteria. Only one false negative case could be identified. The remaining 151 patients are true negative cases and no false positive case could be disclosed. The overall sensitivity, specificity and accuracy of CT in diagnosing gallstone ileus were 93%, 100%; and 99%, respectively. Surgical exploration was performed in 13 patients of gallstone ileus with ectopic stones sized larger than 3 cm. One patient recovered uneventfully following conservative treatment with an ectopic stone sized 2 cm in the long axis. Conclusion: Contrast enhanced CT imaging offered crucial evidence not only for the diagnosis of gallstone ileus but also for decision making in management strategy.

Original languageEnglish
Pages (from-to)2142-2147
Number of pages6
JournalWorld Journal of Gastroenterology
Volume11
Issue number14
Publication statusPublished - Apr 14 2005
Externally publishedYes

Fingerprint

Ileus
Gallstones
Air
Decision Making
Urinary Bladder

Keywords

  • CT
  • Gallstone ileus

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Yu, C. Y., Lin, C. C., Shyu, R. Y., Hsieh, C. B., Wu, H. S., Tyan, Y. S., ... Chen, C. Y. (2005). Value of CT in the diagnosis and management of gallstone ileus. World Journal of Gastroenterology, 11(14), 2142-2147.

Value of CT in the diagnosis and management of gallstone ileus. / Yu, Chih Yung; Lin, Chang Chyi; Shyu, Rong Yaun; Hsieh, Chung Bao; Wu, Hurng Sheng; Tyan, Yeu Sheng; Hwang, Jen I.; Liou, Chang Hsien; Chang, Wei Chou; Chen, Cheng Yu.

In: World Journal of Gastroenterology, Vol. 11, No. 14, 14.04.2005, p. 2142-2147.

Research output: Contribution to journalArticle

Yu, CY, Lin, CC, Shyu, RY, Hsieh, CB, Wu, HS, Tyan, YS, Hwang, JI, Liou, CH, Chang, WC & Chen, CY 2005, 'Value of CT in the diagnosis and management of gallstone ileus', World Journal of Gastroenterology, vol. 11, no. 14, pp. 2142-2147.
Yu CY, Lin CC, Shyu RY, Hsieh CB, Wu HS, Tyan YS et al. Value of CT in the diagnosis and management of gallstone ileus. World Journal of Gastroenterology. 2005 Apr 14;11(14):2142-2147.
Yu, Chih Yung ; Lin, Chang Chyi ; Shyu, Rong Yaun ; Hsieh, Chung Bao ; Wu, Hurng Sheng ; Tyan, Yeu Sheng ; Hwang, Jen I. ; Liou, Chang Hsien ; Chang, Wei Chou ; Chen, Cheng Yu. / Value of CT in the diagnosis and management of gallstone ileus. In: World Journal of Gastroenterology. 2005 ; Vol. 11, No. 14. pp. 2142-2147.
@article{27245bd531ff4cca8ec8fc6b5ec49886,
title = "Value of CT in the diagnosis and management of gallstone ileus",
abstract = "Aim: To retrospectively establish the diagnostic criteria of gallstone ileus on CT, and to prospectively apply these criteria to determine the diagnostic accuracy of CT to confirm or exclude gallstone ileus in patients who presented with acute small bowel obstruction (SBO). Another purpose was to ascertain whether the size of ectopic gallstones would affect treatment strategy. Methods: Fourteen CT scans in cases of proved gallstone ileus were evaluated retrospectively by two radiologists for the presence or absence of previously reported CT findings to establish the diagnostic criteria. These criteria were applied in a prospective contrast enhanced CT study of 165 patients with acute SBO, which included those 14 cases of gallstone ileus. The hard copy images of 165 CT studies were reviewed by a different group of two radiologists but without previous knowledge of the patient's final diagnosis. All CT data were further analyzed to determine the diagnostic accuracy of gallstone ileus when using CT in prospective evaluation of acute SBO. The size of ectopic gallstone on CT was correlated with the clinical course. Results: The diagnostic criteria of gallstone ileus on CT were established retrospectively, which included: (1) SBO; (2) ectopic gallstone; either rim-calcified or total-calcified; (3) abnormal gall bladder with complete air collection, presence of air-fluid level, or fluid accumulation with irregular wall. Prospectively, CT confirmed the diagnosis in 13 cases of gallstone ileus with these three criteria. Only one false negative case could be identified. The remaining 151 patients are true negative cases and no false positive case could be disclosed. The overall sensitivity, specificity and accuracy of CT in diagnosing gallstone ileus were 93{\%}, 100{\%}; and 99{\%}, respectively. Surgical exploration was performed in 13 patients of gallstone ileus with ectopic stones sized larger than 3 cm. One patient recovered uneventfully following conservative treatment with an ectopic stone sized 2 cm in the long axis. Conclusion: Contrast enhanced CT imaging offered crucial evidence not only for the diagnosis of gallstone ileus but also for decision making in management strategy.",
keywords = "CT, Gallstone ileus",
author = "Yu, {Chih Yung} and Lin, {Chang Chyi} and Shyu, {Rong Yaun} and Hsieh, {Chung Bao} and Wu, {Hurng Sheng} and Tyan, {Yeu Sheng} and Hwang, {Jen I.} and Liou, {Chang Hsien} and Chang, {Wei Chou} and Chen, {Cheng Yu}",
year = "2005",
month = "4",
day = "14",
language = "English",
volume = "11",
pages = "2142--2147",
journal = "World Journal of Gastroenterology",
issn = "1007-9327",
publisher = "WJG Press",
number = "14",

}

TY - JOUR

T1 - Value of CT in the diagnosis and management of gallstone ileus

AU - Yu, Chih Yung

AU - Lin, Chang Chyi

AU - Shyu, Rong Yaun

AU - Hsieh, Chung Bao

AU - Wu, Hurng Sheng

AU - Tyan, Yeu Sheng

AU - Hwang, Jen I.

AU - Liou, Chang Hsien

AU - Chang, Wei Chou

AU - Chen, Cheng Yu

PY - 2005/4/14

Y1 - 2005/4/14

N2 - Aim: To retrospectively establish the diagnostic criteria of gallstone ileus on CT, and to prospectively apply these criteria to determine the diagnostic accuracy of CT to confirm or exclude gallstone ileus in patients who presented with acute small bowel obstruction (SBO). Another purpose was to ascertain whether the size of ectopic gallstones would affect treatment strategy. Methods: Fourteen CT scans in cases of proved gallstone ileus were evaluated retrospectively by two radiologists for the presence or absence of previously reported CT findings to establish the diagnostic criteria. These criteria were applied in a prospective contrast enhanced CT study of 165 patients with acute SBO, which included those 14 cases of gallstone ileus. The hard copy images of 165 CT studies were reviewed by a different group of two radiologists but without previous knowledge of the patient's final diagnosis. All CT data were further analyzed to determine the diagnostic accuracy of gallstone ileus when using CT in prospective evaluation of acute SBO. The size of ectopic gallstone on CT was correlated with the clinical course. Results: The diagnostic criteria of gallstone ileus on CT were established retrospectively, which included: (1) SBO; (2) ectopic gallstone; either rim-calcified or total-calcified; (3) abnormal gall bladder with complete air collection, presence of air-fluid level, or fluid accumulation with irregular wall. Prospectively, CT confirmed the diagnosis in 13 cases of gallstone ileus with these three criteria. Only one false negative case could be identified. The remaining 151 patients are true negative cases and no false positive case could be disclosed. The overall sensitivity, specificity and accuracy of CT in diagnosing gallstone ileus were 93%, 100%; and 99%, respectively. Surgical exploration was performed in 13 patients of gallstone ileus with ectopic stones sized larger than 3 cm. One patient recovered uneventfully following conservative treatment with an ectopic stone sized 2 cm in the long axis. Conclusion: Contrast enhanced CT imaging offered crucial evidence not only for the diagnosis of gallstone ileus but also for decision making in management strategy.

AB - Aim: To retrospectively establish the diagnostic criteria of gallstone ileus on CT, and to prospectively apply these criteria to determine the diagnostic accuracy of CT to confirm or exclude gallstone ileus in patients who presented with acute small bowel obstruction (SBO). Another purpose was to ascertain whether the size of ectopic gallstones would affect treatment strategy. Methods: Fourteen CT scans in cases of proved gallstone ileus were evaluated retrospectively by two radiologists for the presence or absence of previously reported CT findings to establish the diagnostic criteria. These criteria were applied in a prospective contrast enhanced CT study of 165 patients with acute SBO, which included those 14 cases of gallstone ileus. The hard copy images of 165 CT studies were reviewed by a different group of two radiologists but without previous knowledge of the patient's final diagnosis. All CT data were further analyzed to determine the diagnostic accuracy of gallstone ileus when using CT in prospective evaluation of acute SBO. The size of ectopic gallstone on CT was correlated with the clinical course. Results: The diagnostic criteria of gallstone ileus on CT were established retrospectively, which included: (1) SBO; (2) ectopic gallstone; either rim-calcified or total-calcified; (3) abnormal gall bladder with complete air collection, presence of air-fluid level, or fluid accumulation with irregular wall. Prospectively, CT confirmed the diagnosis in 13 cases of gallstone ileus with these three criteria. Only one false negative case could be identified. The remaining 151 patients are true negative cases and no false positive case could be disclosed. The overall sensitivity, specificity and accuracy of CT in diagnosing gallstone ileus were 93%, 100%; and 99%, respectively. Surgical exploration was performed in 13 patients of gallstone ileus with ectopic stones sized larger than 3 cm. One patient recovered uneventfully following conservative treatment with an ectopic stone sized 2 cm in the long axis. Conclusion: Contrast enhanced CT imaging offered crucial evidence not only for the diagnosis of gallstone ileus but also for decision making in management strategy.

KW - CT

KW - Gallstone ileus

UR - http://www.scopus.com/inward/record.url?scp=20244381533&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=20244381533&partnerID=8YFLogxK

M3 - Article

C2 - 15810081

AN - SCOPUS:20244381533

VL - 11

SP - 2142

EP - 2147

JO - World Journal of Gastroenterology

JF - World Journal of Gastroenterology

SN - 1007-9327

IS - 14

ER -