Presentation
History of generalized abdominal pain + two episodes of bilious vomiting. The abdomen is diffusely tender with peritonitic signs and sluggish bowel sounds. ? Obstruction/perforation
Patient Data
Age: 90 years
Gender: Male
From the case:
Gallstone ileus
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There is chronic cholecystitis with a large cholecystoduodenal fistula.
There is associated small bowel dilatation and an intraluminal gallstone in keeping with gallstone ileus.
Case Discussion
Classic gallstone ileus triad (Rigler triad) of small bowel obstruction, gas within the biliary tree, and gallstone is demonstrated.
The patient underwent operative reduction of small bowel obstruction and repair of the cholecystoduodenal fistula with additional cholecystectomy.
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