Gallstone Ileus: A Rare Cause of Small Bowel Obstruction

Abstract

A 71-year-old woman with a history of hypertension presented to the Emergency Department with nausea, vomiting, and vague abdominal cramping for 3 days. She had not had a bowel movement during this time, but continued to pass minimal flatus. Her only surgical history was an uncomplicated hysterectomy many years prior. Her vital signs were normal on arrival and her abdominal examination was notable for mild upper abdominal tenderness without guarding, mild distension, and normal bowel sounds. Initial laboratory values demonstrated a leukocytosis (20.8 × 109/L) and an elevated lactate (2.3 mmol/L).