Highlights • Underline the possibility that a gallstone ileus can be a possibility of bowel obstruction in the elderly population. • Stimulate discussion about the surgical management of gallstone ileus and cholecystic-duodenal fistula. • Abdominal CT scan is the preferred investigation for a timely diagnosis.
Introduction Gallstone ileus (GI) is characterized by a mechanical occlusion of the ileal lumen as a result of migration of one or more gallstones in the intestinal tract. Less than 1–4% of all cases of intestinal obstruction are derived from this etiology (1,2,3). Case report We present a case of small intestinal obstruction owing to a large gallstone in lower ileum in a 66 years old woman. The diagnosis was made by computed tomography, and treated successfully with an enterotomy, with a removal of a 5 cm gallstone, carried out through a longitudinal incision on the antimesenteric border. Post-operative course presented no adverse effects. Conclusion Gallstone ileus should be considered in case of bowel obstruction in the elderly population. Abdominal CT scan is the preferred investigation for a timely diagnosis.