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.