Gallstone Ileus

Gallstone ileus is obstruction (usually ileocecal valve) from a large gallstone eroding through cholecystoenteric fistula, in elderly patients, presenting with intermittent abdominal pain, distension, and vomiting. Treatment: NPO; IV fluids; nasogastric decompression; surgical enterolithotomy (remove stone); bowel resection if necrotic; one-stage vs two-stage cholecystectomy/fistula repair depending on stability; monitor for ischemia; follow-up; imaging (Rigler triad: small-bowel obstruction, pneumobilia, ectopic stone).

Common Symptoms

Intermittent abdominal pain; distension; vomiting; in elderly; by gallstone fistula

Causes and Pathogenesis

Gallstone erodes into bowel and impacts at ileocecal valve.

Treatment

Surgical enterolithotomy; NPO/IV fluids; resection if necrotic; treat cholecystitis

Preventive Measures

Treat gallstones; early cholecystectomy.

Department to Visit

It is recommended to visit the Gastrointestinal-surgery/Emergency department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.