Introduction:

gallstone ileus is a rare entity, defined as the presence of a mechanical biliary obstruction by impaction of one or more large gallstone within the gastrointestinal tract. It is the cause of 1 to 4% of all cases of bowel obstruction.

Case report:

36 year old male with epigastric abdominal pain, later generalized, gastroalimentary emesis and gastro biliary, no bowel evacuation. Denies surgical interventions, he had vesicular lithiasis for one year. Physical examination pale skin, distended abdomen with no peristalsis, muscular resistance and positive rebound, tympanic and high-pitched bowl sound were audible. Blood test finding’s revealed an elevated leukocyte (14.1 × 10 cells/L), Na 122 mmol/L, TP 13.4, TpT 29, albumin 4.5, BT 1.5, BD 0.5 and BI 1.0. Computed tomography (CT) scan demonstrated distention of the jejunal loops with retention of fluid content, ectopic gallstone and pneumobilia. Exploratory laparotomy was performed for longitudinal enterotomy which ended up in gallstone extraction.

Conclusions:

CT scan should be used for diagnosis of biliary ileus and the most advantageous and safe surgical option should be chosen.

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