Gallstone ileus and a three centimeters stone in terminal ileum: a case report

  Abstract   Gallstone ileus is a rare complication of cholelithiasis found in less than 0.5% of   patients. It is an uncommon cause of small bowel obstruction, accounting for 1% to   3% of all mechanical bowel obstructions and over 25% of nonstrangulated bowel obstructions in patients older than 65 years with a female predominance.   We report a 60-year-old woman who was referred to our hospital because of abdominal   pain, nausea, vomiting and constipation forty days prior to admission. An upright abdominal X-ray showed air fluid levels and an oval calcified opacity in the   region of right iliac fossa. The ultrasonographic examination revealed air in billiary   tree and several small stones in the gallbladder. Follow up of abdominopelvic CT   scan showed severe distention of small intestinal loops, pneumobilia and a 3cm-calcified   intraluminal mass. The clinical diagnosis of gallstone illeus was made, but unfortunately   her general condition worsened with the decline in Glasgow Coma Scale   declined since she was suffered an extensive cerebrovascular accident and eventually   she died of cardiac arrest. Inspired by the mentioned case we reviewed the literature   on the cause, diagnosis and treatment of gallstone ileus.