An 88-year-old woman was seen at the emergency department with sudden onset of abdominal pain and nausea. She had been constipated for a week. Medical history was positive for arterial hypertension, diabetes mellutis type II, and heart failure. Laboratory findings showed an elevation of cholestatic liver enzymes. CRP was within normal limits. An upright radiograph of the abdomen showed multiple air fluid levels (F) in the small bowel consistent with obstruction. Pneumobilia (short arrow) was also seen as well as an obstructing gallstone (long arrow). A CT of the abdomen was performed. This showed pneumobilia (long arrow), a small bowell faeces sign (white asterisk) in the jejenum consistent with obstruction, and a non radioopaque gallstone in the ileum (dark asterisk). A CT scan from a few years earlier shows signs of cholecystitis and the non radioopaque gall stone (dark asterisk).The patient was treated with laparoscopic enterotomy with removal of the gallstone and cholecystectomy. The cholecystoduodenal fistula was demonstrated.
How to Cite:
De Smet K, De Maeseneer M, Talebian YA, Ilsen B, Dewachter P, De Mey J. Rigler’s triad in an 88-year-old woman. JBR-BTR. 2010;93(6):324. DOI: http://doi.org/10.5334/jbr-btr.357