{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T13:55:14Z","timestamp":1791467714892,"version":"4.3.4"},"reference-count":8,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"vor","delay-in-days":86,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Gallstone ileus is an uncommon complication of cholelithiasis leading to mechanical small bowel obstruction that typically affects geriatric populations with significant baseline medical conditions. The optimal management approach is highly debated, specifically when choosing between simple emergency enterolithotomy alone or a complex one-stage definitive biliary procedure in high-risk patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 79-year-old male with an ECOG performance status of 2, ASA Class IV risk classification, and known severe ischemic heart disease presented with acute mechanical small bowel obstruction. Preoperative contrast-enhanced computed tomography (CT) and subsequent emergency laparoscopic exploration identified an oversized, calcified intraluminal gallstone measuring 7\u2009\u00d7\u20094\u00a0cm impacted within the terminal ileum. A laparoscopic enterolithotomy was successfully performed without a concomitant biliary intervention. The immediate postoperative course was complicated by an acute non-ST-elevation myocardial infarction (NSTEMI) detected via postoperative ECG. Following successful stabilization, the patient recovered gastrointestinal function and was safely discharged home after one week with structured outpatient cardiology follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This case shows that an isolated laparoscopic enterolithotomy can serve as a technically feasible option for large gallstone ileus in selected high-risk patients when executed by experienced hands. However, clinicians must maintain extensive vigilance regarding perioperative cardiovascular strain, as the surgical resolution of obstruction must be balanced against severe potential cardiac complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12893-026-04045-1","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T11:06:52Z","timestamp":1784027212000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Laparoscopic enterolithotomy for large gallstone ileus in an elderly high-risk patient: a case report"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9764-3333","authenticated-orcid":false,"given":"Marei","family":"Alshandeer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"issue":"6","key":"4045_CR1","first-page":"441","volume":"60","author":"RM Reisner","year":"1994","unstructured":"Reisner RM, Cohen JR. Gallstone ileus: a review of 1001 reported cases. Am Surg. 1994;60(6):441\u20136.","journal-title":"Am Surg"},{"issue":"4","key":"4045_CR2","first-page":"527","volume":"153","author":"F Glenn","year":"1981","unstructured":"Glenn F, Reed C, Grafe WR. Biliary enteric fistula. Surg Gynecol Obstet. 1981;153(4):527\u201331.","journal-title":"Surg Gynecol Obstet"},{"issue":"1","key":"4045_CR3","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1016\/j.ejrad.2003.11.011","volume":"50","author":"F Lassandro","year":"2004","unstructured":"Lassandro F, Gagliardi N, Scuderi M, Pinto A, Gatta G, Mazzeo R. Gallstone ileus: analysis of radiological findings in 27 patients. Eur J Radiol. 2004;50(1):23\u20139.","journal-title":"Eur J Radiol"},{"key":"4045_CR4","doi-asserted-by":"publisher","first-page":"483","DOI":"10.21614\/chirurgia.3046","volume":"119","author":"D Vadher","year":"2024","unstructured":"Vadher D, Zacken A, Shah V, Silmi M, Aguilar LS, Patel K, et al. The Rolling Stones: A Systematic Review and Meta-Analysis of the Management of Gallstone Ileus. Chirurgia (Bucur). 2024;119:483\u2013514.","journal-title":"Chirurgia (Bucur)"},{"issue":"2","key":"4045_CR5","first-page":"147","volume":"14","author":"D Mart\u00ednez Ramos","year":"2022","unstructured":"Mart\u00ednez Ramos D, et al. Surgical treatment of gallstone ileus: less is more. World J Gastrointest Surg. 2022;14(2):147\u201355.","journal-title":"World J Gastrointest Surg"},{"key":"4045_CR6","doi-asserted-by":"publisher","first-page":"106171","DOI":"10.1016\/j.ijscr.2021.106171","volume":"85","author":"M Orellana","year":"2021","unstructured":"Orellana M, et al. Laparoscopic management of gallstone ileus: case report and literature review. Int J Surg Case Rep. 2021;85:106171.","journal-title":"Int J Surg Case Rep"},{"key":"4045_CR7","doi-asserted-by":"publisher","first-page":"100203","DOI":"10.1016\/j.sipas.2023.100203","volume":"14","author":"V Rao","year":"2023","unstructured":"Rao V, DeLeon G, Becker T, Duggan B, Pei KY. Comparing outcomes of operative management of intestinal obstruction due to gallstone ileus using NSQIP database. Surg Pract Sci. 2023;14:100203.","journal-title":"Surg Pract Sci"},{"issue":"9","key":"4045_CR8","doi-asserted-by":"publisher","first-page":"3956","DOI":"10.1177\/00031348231175130","volume":"89","author":"M Ayres","year":"2023","unstructured":"Ayres M, Kim C, Ramos T, Burns B. Gallstone ileus with persistent cholelithiasis. Am Surg. 2023;89(9):3956\u20138.","journal-title":"Am Surg"}],"container-title":["BMC Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12893-026-04045-1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12893-026-04045-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12893-026-04045-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T13:02:30Z","timestamp":1791464550000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12893-026-04045-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,14]]},"references-count":8,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["4045"],"URL":"https:\/\/doi.org\/10.1186\/s12893-026-04045-1","relation":{},"ISSN":["1471-2482"],"issn-type":[{"value":"1471-2482","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,14]]},"assertion":[{"value":"19 May 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Not applicable. Single case reports are explicitly exempt from formal Institutional Review Board (IRB) review at our institution per local regulatory policy.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"678"}}