Gallstone ileus

Case contributed by Dr Ian Bickle

Presentation

Hospital admission for past 14 days with ultrasound proven calculus cholecystitis. Increasing abdominal distension and now vomiting.

Patient Data

Age: 75 years
Gender: Female

Gallstones.

Faint round calcific density in the right flank.

Dilated gas filled small bowel.

Air in the biliary tree.

Thickened collapsed gallbladder with a fistulous communication to the adjacent duodenum.

Mild-moderate dilated small bowel down to the ileum which contains a large laminated intraluminal gallstone.

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