XXXX : One-stage surgery in a @entity1 with intermittent obstruction.

@entity1 @entity5990 @entity2963 @entity1321 @entity4570
@entity5990 , an uncommon complication of @entity2963 , is described as a mechanical @entity1321 due to impaction of one or more large @entity5990 within the gastrointestinal tract. The clinical presentation is variable, depending on the site of obstruction, manifested as acute, intermittent or chronic episodes. A 51-year-old female @entity1 was referred to our hospital with 3 events of @entity1321 during the previous 7 d. At admission, there were clinical signs of @entity1321 ; abdominal film demonstrated dilated bowel loops, air-fluid levels and a vague image of a stone in the inferior left quadrant. Once stabilized, a laparotomy was performed. Surgical findings were distention of the jejunum and ileum proximal to a palpable stone in the ileum as well as @entity5990 and a @entity4570 in the gallbladder. An enterolithotomy, repair of the @entity4570 and cholecystectomy were performed. The postoperative course was uneventful. There is no uniform surgical procedure for this disease. When the @entity1 is too ill or when biliary surgery is not advisable, an enterolithotomy is the best option. The one-stage procedure should be the offered to adequately stabilized @entity1 when local and general conditions, such as good cardiorespiratory and metabolic reserve permit a more prolonged surgical procedure.
