Gallstone Ileus: A Case Report

Intestinal obstruction is a common emergency in surgical practice but rarely, it may be caused by gallstone impaction leading to a condition what is called as “Gallstone Ileus” (GI). The intestinal obstruction due to Gallstone impaction occurs due to a fistula in the biliary-enteric tract. It is a rare presentation accounting for only 0.1% of all causes of intestinal obstruction. A 70 year old female, presented with features of Intestinal obstruction for 1 week. Ultrasound of the abdomen revealed distended bowel loops and contracted gallbladder. Computerized tomography scan suggested contracted gallbladder with hyperdense contents with air foci in the gallbladder and common bile duct with a hypodense lesion in the jejunal loop with air foci and calcifications causing luminal occlusion with dilated proximal bowel loop. Laparotomy revealed a 3 cm stone impacted in jejunum 2 feet distal to Duodenojejunal (DJ) flexure with proximal dilatation of the jejunum. Enterotomy was done and the stone was removed. The bowel was decompressed and enterotomy was closed primarily. The patient has been on follow up without any complaints for the last 6 months.