Gall stone ileus- a rare cause of intestinal obstruction: a case report and review of literature

Abstract

Gall stone ileus is an uncommon and potentially serious complication of cholelithiasis. The formation of fistula between the gallbladder and duodenum may allow the gallstone to enter the intestinal tract. It carries a significant morbidity and mortality due to the advanced age of patients and high incidence of concomitant diseases. Here we report a case of a 75-year-old male patient who is a known diabetic, hypertensive and COPD with a recent history of surgery for obstructed umbilical hernia. He presented in the emergency department with small bowel obstruction owing to a large stone in ileum. The clinical presentation, radiological features, operative procedure and literature review are presented.

Stone in the distal jejunum presenting as small bowel obstruction: A case report

“…Gallstone ileus is usually seen in patients with recurrent attacks of acute calculus cholecystitis harbouring larger gallstones [ 5 ]. The most common fistulas are cholecystoduodenal, while cholecystocolic and cholecystogastric fistulas have also been reported [ 1 , 2 , 4 ].…”

“…Stones ≤2.5 cm is size usually pass spontaneously while stones >2.5 cm in size are obstructed mostly at the site of ileocecal valve hence there seems to be a possible role of nasogastric decompression and fluid resuscitation in the management of gallstone ileus [ 4 , 7 ]. However, stones obstructing the sigmoid colon, proximal ileum, jejunum, duodenum, and gastric outlet have also been reported [ 5 , 6 ].…”