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Case Series
Acute cholecystitis as a complication of diverting loop ileostomy: A case series and narrative review
1 Department of General Surgery, Austin Health, Heidelberg, Victoria, Australia
2 Faculty of Medicine, Nursing and Health Science, Monash University, Clayton, Victoria, Australia
3 Department of General Surgery, Mulgrave Private Hospital, Mulgrave, Victoria, Australia
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Rama HG Mikhail
Austin Health, Heidelberg, Victoria,
Australia
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Article ID: 100124Z12RM2023
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Mikhail RHG, Chee M, McKay SC, Syrrakos K. Acute cholecystitis as a complication of diverting loop ileostomy: A case series and narrative review. J Case Rep Images Surg 2023;9(2):16–21.ABSTRACT
Introduction: Diverting ileostomy is increasingly utilized in modern colorectal surgery for the management of colorectal cancer and inflammatory bowel disease (IBD) among other bowel pathologies. Cholelithiasis has known associations with ileostomy and IBD, potentially caused by changes to enterohepatic circulation and cholesterol absorption in the gallbladder. However, cases of cholecystitis following ileostomy have not been reported across the literature.
Case Series: We present three cases of cholecystitis following diverting loop ileostomy in a 56-year-old female, 74-year-old female, and 73-year-old female. A digital literature search was conducted on databases PubMed and EMBASE in February 2023 covering literature from 1974 to 2023 to identify any further cases; however, none were identified. To our knowledge, these are the first reported cases of cholecystitis following ileostomy.
Conclusion: We believe these three cases highlight that developing symptomatic gallstones following diverting ileostomy occurs, and patients should be carefully counseled of the risks preoperatively, and be educated of gallstone-related symptoms to enable early engagement of upper gastrointestinal surgeons for treatment. Additionally, we recommend preoperative gallbladder imaging and close monitoring prior to and after ileostomy formation for development of gallstone complications. Ultimately, this case series and narrative review lay the groundwork for further research investigating any causality between diverting loop ileostomy formation and development of complications of gallstone disease.
Keywords: Cholecystitis, Cholelithiasis, Consent, Diverting ileostomy
SUPPORTING INFORMATION
Author Contributions
Rama HG Mikhail - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Marcel Chee - Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Siobhan C McKay - Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Konstantinos Syrrakos - Substantial contributions to conception and design, Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2023 Rama HG Mikhail et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
