Gallstone ileus

Case contributed by Harshit Phogat
Diagnosis certain


Abdominal pain, nausea, and vomiting.

Patient Data

Age: 60 years
Gender: Male
  • a cholecystoenteric fistula with intraluminal gas is demonstrated between the gallbladder and the duodenum

  • presence of an obstructed calculus of diameter 22mm located at the mid ileum with proximal dilatation of small bowel loops and stomach

  • small volume intraperitoneal free fluid

Case Discussion

These radiologic findings were consistent with small bowel obstruction secondary to gallstone ileus. In this case, the patient had a history of chronic cholecystitis facilitating the formation of a cholecystoenteric fistula and migration of a gallstone into the small bowel. This gallstone subsequently became impacted at the mid ileum causing a small bowel obstruction.

The patient underwent a laparoscopic-assisted enterotomy for the removal of the gallstone with an uncomplicated recovery. The cholecystoenteric fistula was followed up as an outpatient with a repeat scan for consideration of a delayed procedure for fistula repair.

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