Gallstone Ileus

Small bowel obstruction caused by the impaction of a gallstone within the lumen of the small intestine

Aetiology

  • See Gallstones

Pathophysiology

  • Gallstone enters the small intestine via a fistula between the gallbladder and duodenum

Clinical presentation

  • Intermittent symptoms of nausea, vomiting, abdominal distension, and pain
  • Eventually results in distal small bowel obstruction

Investigations

  • Plain AXR demonstrates small bowel obstruction, ultrasound shows biliary tract pathology and CT makes the final diagnosis

Management

  • Urgent laparotomy to remove stone, interval cholecystectomy in 3 months