Gallstone ileus: Unusual complication of cholelithiasis

Abstract

Gallstone ileus is an unusual complication of gallstone disease. However, gallstone ileus is a serious cause of mechanical bowel obstruction. Gallstone ileus affects older adult patients with underlying medical diseases. It occurs when a gallstone passes through a fistula between the gallbladder and small bowel before becoming obstructed at the ileocecal valve. The symptom includes episodic obstruction caused by the stone rolling through the bowel lumen. Gallstone impaction produces abdominal pain and vomiting, which subside as the gallstone becomes disimpacted, only to recur again as the stone lodges in the more distal bowel lumen. The mean symptom duration before the emergency department visit is approximately 5 days, similar to our patient. Computed tomography is widely used to confirm the diagnosis.

Keywords

• cholelithiasis
• gallstone ileus
• gastroduodenal fistula