Abstract

Gallstone ileus is an unusual complication of cholelithiasis that occurs in less than 0.5% of patients who present with a bowel obstruction. Findings may include gallbladder wall thickening, pneumobilia, obstruction, and presence of gallstones. 60% of cases are due to cholecystoduodenal fistulas, although cholecystocolonic and cholecystogastric fistulas may have the same outcome. The mortality rate ranges from 4.5 to 25%, 5 to 10 times higher than those of other causes of mechanical bowel obstruction. May present as intermittent pain, resulting in delayed diagnosis. Treatment mainly consists of surgical removal of the stone causing the obstruction and possibly cholecystectomy.