Presentation
3 days history of constipation, upper abdominal discomfort, and new-onset vomiting.
Patient Data
Age: 85 years
Gender: Male
From the case:
Gallstone ileus
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- pneumobilia (air in the biliary tree)
- a large rounded calculus is identified in the left upper abdominal quadrant with a paucity of bowel gas in this region
- air-fluid level seen in a prominent loop of bowel in the right upper quadrant
From the case:
Gallstone ileus
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- pneumobilia in the liver
- formation of a choledochoduodenal fistula from the gallbladder to the second duodenal segment
- large calculus (50 x 28 mm) located in the proximal jejunum with upstream small bowel and gastric dilatation
- small right-sided pleural effusion
Case Discussion
The patient underwent a cholecystectomy and enterolithotomy with removal of gallstone, with an uncomplicated post-operative period.