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Reading: Rigler’s triad in an 88-year-old woman

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Rigler’s triad in an 88-year-old woman

Authors:

K De Smet ,

Department of Radiology, Univeristeit Ziekenhuis Brussel, Brussels, Belgium.
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M De Maeseneer,

Department of Radiology, Univeristeit Ziekenhuis Brussel, Brussels, Belgium.
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Y A Talebian,

Department of Radiology, Univeristeit Ziekenhuis Brussel, Brussels, Belgium.
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B Ilsen,

Department of Radiology, Univeristeit Ziekenhuis Brussel, Brussels, Belgium.
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P Dewachter,

Department of Radiology, Univeristeit Ziekenhuis Brussel, Brussels, Belgium.
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J De Mey

Department of Radiology, Univeristeit Ziekenhuis Brussel, Brussels, Belgium.
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Abstract

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. Journal of the Belgian Society of Radiology. 2010;93(6):324. DOI: http://doi.org/10.5334/jbr-btr.357
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Published on 17 Jun 2010.
Peer Reviewed

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