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Gallstone ileus

Case contributed by Chris O'Donnell
Diagnosis certain

Presentation

Abdominal pain, no passage of wind and vomiting. Bowel obstruction?

Patient Data

Age: 60 years
Gender: Female
ct

A large stone of around 2 cm is sitting in the ileum with markedly distended fluid-filled proximal small bowel. Note a fistula between the thick-walled gallbladder and duodenum (cholecystoduodenal fistula) with gas in the gallbladder lumen. All are features typical of gallstone ileus.

Case Discussion

Gallstone ileus occurs when a large gallbladder stone erodes into the duodenum via a fistula, eventually obstructing the ileal lumen usually some centimeters proximal to the ileocecal junction.

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