Gallstone ileus: a complication least expected

Gallstone ileus is an uncommon cause of mechanical small bowel obstruction. A high index of suspicion is needed so as to avoid the morbidity and mortality related to this condition in geriatric population in which it occurs more frequently. A 60-year old female presented with signs and symptoms of acute small bowel obstruction. Surgery a large stone was found impacted in the terminal ileum with a fistulous tract between the gallbladder and duodenum