Gallstone ileus

Case contributed by Albina Polianskaia
Diagnosis certain


Abdominal pain, nausea and bilious vomiting. No signs of peritoneal irritation.

Patient Data

Age: 80 years
Gender: Male

Gallbladder wall thickening, cholelithiasis, and a small amount of pericholecystic fluid. Pneumobilia in the left hepatic lobe. Cholecystoenteric fistula with gallstone impacted in the second part of the duodenum. Another gallstone in the distal ileum resulted in retrograde small bowel obstruction.

Multiple bilateral simple renal cysts. Signs of aspiration pneumonitis and mild right pleural effusion.

Case Discussion

Gallstone ileus is a rare form of mechanical intestinal obstruction and is a complication of chronic cholelithiasis. It occurs predominantly in the older age group and the female gender. The symptoms are non-specific, therefore the diagnosis is often delayed.

In our case, ileal enterotomy, gallstone extraction, and cholecystoduodenal fistula closure were performed with early recovery.

Case courtesy of Dr. Xavier Molina Arcas

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