Presentation
Abdominal pain, distension and repeated vomiting.
Patient Data
Dilated fluid-filled stomach, duodenum and jejunal loops (maximum diameter about 4 cm) until the mid jejunum where a dense laminated structure measuring approximately 2.5 cm is seen, the distal bowel loops are collapsed.
Pneumobilia in the intra and extrahepatic bile ducts.
Collapsed gall bladder with thickened edematous wall and few tiny air foci noted inside.
Multiple colonic diverticula are noted with no significant inflammatory changes.
Intraoperative photo of the large migrated gallstone extracted from the small bowel.
Case Discussion
The patient went for surgery and a large stone was extracted from the dilated obstructed jejunum, the bowel was viable.
The case shows the classical findings of Rigler's triad.
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