Obstructive quandary: A comprehensive case report of gallstone ileus

Abstract

Gallstone ileus (GI), an infrequent but complex complication of cholelithiasis, poses a multifaceted challenge in the field of general surgery. We present a case report of a 99-year-old male with GI, characterized by mechanical obstruction within the small bowel due to gallstone impaction, and offer a review of the literature on this subject. GI emerges as a late-stage complication of gallstone disease, primarily manifesting in elderly individuals, with a higher incidence among women. The condition is driven by the migration of gallstones through fistulas, most commonly forming connections with the small bowel. Diagnosis is intricate due to nonspecific clinical symptoms, often requiring imaging modalities like abdominal CT scans. Treatment necessitates surgical intervention, addressing both intestinal obstruction and cholecystoenteric fistula management. The approach, whether one-stage or sequential, is guided by individual patient characteristics.