Gallstone ileus
Discussion:
If you got this case correct in quiz format, then good for you! This is probably as subtle and as difficult as gallstone ileus can be to diagnose.
To make matters worse, we were provided with a history of prior cholecystectomy in this patient, and the cholecystenteric fistula could easily be mistaken for a duodenal diverticulum at first glance. It is rather surprising how non-inflamed the gallbladder appears in this case.
It is very common for a noncalcified gallstone to be difficult to identify in the lumen, as it blends in with the intraluminal contents, as was the case for this patient.
{"caseId":59397,"playlists":[],"playlist_ids_include_case":[]}