https://doi.org/10.4081/crest.2023.12

The Rigler’s triad: a case of gallstone ileus

Vol. 1 No. 1 (2023)
Submitted: May 12, 2023
Accepted: July 2, 2023
Published: July 10, 2023
Rigler’s triad, gallstone ileus, bowel obstruction, cholecystoduodenal fistula
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Authors

  • Giulia Montori • giulia.montori@gmail.com General Surgery Department, ULSS 2 Marca Trevigiana, Vittorio Veneto Hospital, Vittorio Veneto (TV), Italy.
  • Giuseppa Procida General Surgery Department, ULSS 2 Marca Trevigiana, Vittorio Veneto Hospital, Vittorio Veneto (TV), Italy.
  • Andrea Dal Borgo General Surgery Department, ULSS 2 Marca Trevigiana, Vittorio Veneto Hospital, Vittorio Veneto (TV), Italy.
  • Edelweiss Licitra General Surgery Department, ULSS 2 Marca Trevigiana, Vittorio Veneto Hospital, Vittorio Veneto (TV), Italy.
  • Tobia Gobbi General Surgery Department, ULSS 2 Marca Trevigiana, Vittorio Veneto Hospital, Vittorio Veneto (TV), Italy.
  • Francesca Fappiano General Surgery Department, ULSS 2 Marca Trevigiana, Vittorio Veneto Hospital, Vittorio Veneto (TV), Italy.
  • Federica Salemi General Surgery Department, ULSS 2 Marca Trevigiana, Vittorio Veneto Hospital, Vittorio Veneto (TV), Italy.
  • Ferdinando Agresta General Surgery Department, ULSS 2 Marca Trevigiana, Vittorio Veneto Hospital, Vittorio Veneto (TV), Italy.

Rigler’s triad is an extremely rare syndrome that accounts for 4% of all cases of small intestinal obstruction (SBO). This illness is distinguished by three clinical and radiological features: pneumobilia, a severe intestinal blockage, and an abnormally placed gallstone in the gallbladder. An 84-year-old woman arrives at the Emergency Department with symptoms of SBO. The CT scan is essential for detecting the trio. An emergency laparoscopy with an enterotomy and gallstone extraction was conducted successfully. The Rigler’s triad should be suspected in elderly individuals with a history of gallstones in the gallbladder, especially in the emergency scenario. Large and solitary gallstones in the gallbladder that are asymptomatic should be candidates for cholecystectomy. In conclusion, this case is a very didactic instance, particularly because of the crisp CT images that can assist surgeons in identifying gallstone ileus and the mini-invasive method that can also benefit in an emergency context.

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How to Cite

Montori, G., Procida, G., Dal Borgo, A., Licitra, E., Gobbi, T., Fappiano, F., Salemi, F., & Agresta, F. (2023). The Rigler’s triad: a case of gallstone ileus. Case Reports in Emergency Surgery and Trauma, 1(1). https://doi.org/10.4081/crest.2023.12
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