{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:35:05Z","timestamp":1787063705606,"version":"build-2736575974"},"reference-count":15,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,9,20]]},"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:p>Although gallstone disease is classically associated with the inflammatory sequela of cholecystitis, other presentations include gallstone ileus, Mirizzi syndrome, Bouveret syndrome and gallstone ileus. Gallstone ileus occurs when a gallstone passes from a cholecystoduodenal fistula into the gastrointestinal tract and causes obstruction, usually at the ileocaecal valve. It represents an uncommon complication of cholelithiasis, accounting for 1%\u20134% of all cases of mechanical bowel obstruction and 25% of all cases in individuals aged &gt;65 years. It has a female predilection. Clinical presentation depends on the site of the obstruction. Diagnosis can prove challenging with the diagnosis rendered in 50% of cases intraoperatively. The authors present the case of a 79-year-old woman with a 10-day history of abdominal pain, nausea, vomiting and episodes of loose stools. An abdominal radiograph showed mildly distended right small bowel loops. Further investigation with a CT of the abdomen and pelvis demonstrated small bowel obstruction secondary to a 3.3\u2009cm calculus within the small bowel. She underwent a laparotomy and a 5.0\u00d72.5\u2009cm gallstone was evident, causing complete obstruction. An enterolithotomy was performed. Her postoperative course was complicated by Mobitz type II heart block requiring pacemaker insertion. This paper will provide an overview of the clinical presentation, investigations and management of gallstone ileus. It provides a cautionary reminder of considering gallstone ileus in the differential diagnosis in elderly patients presenting with bowel obstruction and a history of gallstone disease.<\/jats:p>","DOI":"10.1136\/bcr-2019-231581","type":"journal-article","created":{"date-parts":[[2019,10,14]],"date-time":"2019-10-14T05:39:13Z","timestamp":1571031553000},"page":"e231581","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Gallstone ileus managed with enterolithotomy"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5499-415X","authenticated-orcid":false,"given":"Louise","family":"Dunphy","sequence":"first","affiliation":[{"name":"Wexham Park Hospital, Slough, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ihsan","family":"Al-Shoek","sequence":"additional","affiliation":[{"name":"Wexham Park Hospital, Slough, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,10,13]]},"reference":[{"key":"2025082800075699000_12.10.e231581.1","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1308\/003588410X12664192076377","article-title":"The operative management of gallstone ileus","volume":"92","author":"Ravikumar","year":"2010","journal-title":"Annals"},{"key":"2025082800075699000_12.10.e231581.2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-195507000-00007"},{"key":"2025082800075699000_12.10.e231581.3","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1111\/j.1445-5994.2011.02552.x","article-title":"Gallstone ileus","volume":"41","author":"Loizides","year":"2011","journal-title":"Intern Med J"},{"key":"2025082800075699000_12.10.e231581.4","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1016\/j.ijscr.2012.12.016","article-title":"Gallstone ileus: one-stage surgery in an elderly patient. one stage surgery in gallstone ileus","volume":"4","author":"Conzo","year":"2014","journal-title":"Int J Surg Case Rep"},{"key":"2025082800075699000_12.10.e231581.5","first-page":"489","article-title":"[Gallstone Ileus: results of analysis of a series of 40 patients]","volume":"24","author":"Rodr\u00edguez Hermosa","year":"2001","journal-title":"Gastroenterol Hepatol"},{"key":"2025082800075699000_12.10.e231581.6","unstructured":"Courvoisier LT . 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