Gallstone Ileus Presenting With Cholelith Emesis and an Incidental Benign Ovarian Fibroma: A Case Report

Abstract

Gallstone ileus (GI) is a rare but important cause of mechanical bowel obstruction associated with high levels of mortality. The classic radiological triad ( Rigler’s triad) of pneumobilia, bowel obstruction and an aberrant gallstone is present in 40-50% of cases. The vomiting of gallstones, “cholelith emesis” , is a rare presentation of cholecystoduodenal fistula with bowel obstruction occurrence of which should prompt investigation for GI. Surgical management with enterolithotomy is the most common treatment option with fewer post-operative complications compared to one-stage procedures. We describe a case of GI in an elderly female patient presenting with cholelith emesis secondary to mid-ileal gallstone impaction and small bowel obstruction with an incidental large pelvic mass requiring emergency enterolithotomy. J Curr Surg. 2015;5(1):137-139 doi: http://dx.doi.org/10.14740/jcs258w