Gallstone ileus is a rare complication of the biliary stone, occurring in 0.3-0.5% of
patients with
cholelithiasis. The mortality rate is high at 12-27% and
early diagnosis and prompt management can improve its
prognosis. An 83-year-old
woman was admitted to the
hospital with
abdominal pain. The
patient previously had a
hysterectomy and had received
radiation therapy for
uterine cancer. Plain abdominal
x-ray showed typical findings of small bowel
ileus with step ladder patterns. Computed
tomography (CT) scan revealed biliary-enteric
fistula with a 3-cm-sized
gallstone in the jejunal loop. Surgical
treatment was planned but due to the
patient's wish,
conservative treatment was provided for 10 days. In the follow-up CT scan, the stone had moved to the distal
ileum but
intestinal perforation was suspected. Ileocecectomy and adhesiolysis were performed and the
patient recovered fully. Here we
report a case of
gallstone ileus that was treated by surgical removal after 10 days of
conservative treatment.