Gallstone ileus

Gallstone ileus refers to small bowel obstruction resulting from the impaction of one or more gallstones after they have migrated through a cholecystoenteric fistula. Gallstone ileus is a rare disease and accounts for about 1−3% of mechanic ileus of the small bowel, but for 25% of all small bowel obstructions in patients older than 65 years.

CT images demonstrate a gallstone ileus

Treating the obstruction, along with cholecystectomy and fistula division, with or without common bile duct exploration in a single stage is the preferred surgical approach for gallstone ileus. Treating the obstruction with enterolithotomy alone is the preferred approach for patients who are poor surgical risks. They are further managed expectantly unless recurrent gallstone ileus or cholecystitis necessitate a definitive biliary procedure as the second stage.

• Ileus

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