Presentation
Abdominal pain and vomiting. No history of gallbladder surgery.
Patient Data
Age: 90 years
Gender: Male
From the case:
Gallstone ileus
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Moderate widened small bowel. No gallstone visible. Gas in the biliary tree is hard to visualize.
From the case:
Gallstone ileus
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Gallbladder not visible. Moderate dilated small bowel, with endoluminal echogenic image with intense posterior shadow that suggests gallstone ileus.
From the case:
Gallstone ileus
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Not believing the radiologist, the surgeon asks for the CT anyway, which confirms the diagnosis of gallstone ileus.
In the coronal plane, it is more evident the cholecystoduodenal fistula with a small calcification inside, and the wide communication with the duodenum. Do not mistake with the adjacent duodenal diverticulum.
Case Discussion
This is a classic example of a classic diagnosis, a favorite of radiology exams.
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