Features consistent with high-grade mechanical distal small-bowel obstruction secondary to gallstone ileus. A decompressed gallbladder demonstrates this with apparent wall thickening, and a cholecystoduodenal fistula at approximately D1 segment. There is a fluid-filled distended stomach with associated dilated fluid-filled small bowel loops. Distal ileal transitional zone with a large, lamellated, gallstone identified, measuring 23.2 mm in maximum diameter. There is no intrahepatic venous gas, no pneumobilia and no pneumatosis intestinalis.
There is evidence of a total hysterectomy. Solitary migrated central intrapelvic metallic sterilisation clip. The adnexa appears normal. There is calcific and non calcific diverticulosis and no acute diverticulitis. The rest of the solid and hollow abdominal and pelvic viscera appear satisfactory. There are no occult intrahepatic, lymphatic, lung base or osseous metastases.