Intended for healthcare professionals

Rapid response to:

Endgames Spot Diagnosis

Losing a marble

BMJ 2016; 354 doi: (Published 26 August 2016) Cite this as: BMJ 2016;354:i4486

Rapid Response:

Re: Losing a marble

Dear Mr. McKay,

Many thanks for your response, I do believe you are correct.

I note Reisner et. al in their review of 1001 gallstone ileus cases, mention that the most common site of gallstone impaction is the terminal ileum AND the ileocecal valve, due to the anatomical small diameter and less active peristalsis.

I can see how the wording in our article tends to suggest the most common site of obstruction is solely at the ileocecal valve, hence I am happy to request a correction - the paragraph in question should read: "The most common site of obstruction is the terminal ileum (B) (fig 2)" - and the words "at the ileocecal valve" be removed.

Yours sincerely,

Adrian Iordache

Competing interests: No competing interests

13 September 2016
Adrian Iordache
Foundation Year 2 House Officer
Paul Young
James Cook University Hospital