Gallstone ileus

Case contributed by Dr Jheferson Contreras Grande

Presentation

Patient with abdominal pain and vomiting.

Patient Data

Age: 70 years
Gender: Female
X-ray

X-ray shows Rigler triad: pneumobilia, small bowel obstruction and ectopic gallstone (projected laterally and to the right of L4-L5). 

Patient with suspected biliary ileus, CT was performed to confirm the diagnosis.

CT

CT shows Rigler triad

CT

CT performed 3 years before shows the gallstone within the gallbladder.

Annotated image

X-ray shows Rigler triad: pneumobilia, small bowel obstruction and ectopic gallstone.

Case Discussion

The patient was operated and the diagnosis of gallstone ileus was confirmed. This case shows Rigler triad, which is uncommon but if it is present the diagnosis is almost certain.

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