What Is Gallstone Ileus and What Are Its Implications?

Abstract

Gallstone ileus is a rare etiology for bowel obstruction that disproportionately affects elderly women. Symptoms are often subacute, making it difficult to diagnose. It results in high morbidity and mortality. A large gallstone, typically >2.5 cm, passes through a biliary-enteric fistula and becomes impacted in the intestine, causing a bowel obstruction. The most frequent site of impaction is the terminal ileum, as it is the narrowest part of the small intestine. Diagnosis is best made by computed tomography and treatment is surgical.