Gallstone Ileus: A Case Report


  • Darmadi Darmadi Department of Internal Medicine, Faculty of Medicine, Universitas Sumatera Utara, Haji Adam Malik General Hospital, Medan, North Sumatera, Indonesia
  • Riska Habriel Ruslie Department of Child Health, Faculty of Medicine, Universitas Prima Indonesia, Medan, North Sumatera, Indonesia
  • Carolus Trianda Samosir Department of Child Health, Perdagangan General Hospital, Simalungun, North Sumatera, Indonesia



cholelithiasis, bowel obstruction, ; enterolithotomy, gallstone, ileus


BACKGROUND: Gallstone ileus (GI) is a mechanical obstruction in the intestinal lumen due to gallstones. Its prevalence is very low, but it possesses a high mortality rate. It is commonly found in older female population.

CASE REPORT: We reported a case of GI in a 61-year-old Chinese female, who presented with acute onset of abdominal pain, nausea, and intermittent vomiting. On water-soluble contrast follow-through examination, she showed total bowel obstruction on the level of terminal ileum due to suspected gallstone. Exploratory laparotomy with procedure of enterolithotomy and stone removal by milking the bowel distal to the stone were performed. Post-operative course was uneventful, but the patient was discharged at post-operative day 8. Furthermore, the patient underwent cholecystectomy and fistula repair in the following days (two-stage surgery). She was followed up in the clinic for 12 months and the patient remained asymptomatic.

CONCLUSION: GI is a rare medical condition with a high mortality rate, commonly affecting females and elder population. It must be considered in a patient with bowel obstruction, especially with a history of cholelithiasis. Many clinicians prefer enterolithotomy alone, followed by cholecystectomy at later date, because of its lower morbidity and report high spontaneous fistula closure.


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Dai X, Li G, Zhang F, Wang XH, Zhang CY. Gallstone ileus: Case report and literature review. World J Gastroenterol. 2013;19(33):5586-9. PMid:24023505

Abich E, Glotzer D, Murphy E. Gallstone ileus: An unlikely cause of mechanical small bowel obstruction. Case Rep Gastroenterol. 2017;11(2):389-95. PMid:29033757

Koc A, Caglayan K, Dogan H, Akkus A. Case report: Gallstone ileus. Isr J Emerg Med. 2009;9:9-12.

Reisner RM, Cohen JR. Gallstone ileus: A review of 1,001 reported cases. Am Surg. 1994;60(6):441-6. PMid:8198337

Rodríguez HJ, Codina CA, Gironès VJ, García JR, Francesch MF, Fernández DA, et al. Gallstone ileus: Results of analysis of a series of 40 patients. Gastroenterol Hepatol. 2001;24(10):489-94. PMid:11730617

Sertkaya M, Emre A, Akbulut S, Vicdan H, Şanlı AN. A typical gallstone ileus: Clinical, radiological, and operational findings. Turk J Gastroenterol. 2019;30(4):377-80. PMid:30457562

Ploneda-Valencia CF, Gallo-Morales M, Rinchon C, Navarro- Muñiz E, Bautista-López CA, de la Cerda-Trujillo LF, et al. Gallstone ileus: An overview of the literature. Rev Gastroenterol Mex. 2017;82(3):248-54. rgmxen.2017.05.001 PMid:28433486

Lobo DN, Jobling JC, Balfour TW. Gallstone ileus: Diagnostic pitfalls and therapeutic successes. J Clin Gastroenterol. 2000;30(1):72- 6. PMid:10636215

Ihara E, Ochiai T, Yamamoto K, Kabemura T, Harada N. A case of gallstone ileus with a spontaneous evacuation. Am J Gastroenterol. 2002;97:1259-60. https://doi. org/10.1111/j.1572-0241.2002.05715.x PMid:12014739

Al-Obaid O. Gallstone ileus: A forgotten rare cause of intestinal obstruction. Saudi J Gastroenterol. 2007;13(1):39-42. https:// PMid:19858612

Nuno-Guzman CM, Arroniz-Jauregui JA, Moreno-Perez PA, Chávez-Solís EA, Esparza-Arias N, Hernández-González CI. Gallstone ileus: One-stage surgery in a patient with intermittent obstruction. World J Gastrointest Surg. 2010;2(5):172-6. https:// PMid:21160869

Nuno-Guzman CM, Marin-Contreras ME, Figueroa-Sanchez M, Corona JL. Gallstone ileus, clinical presentation, diagnostic and treatment approach. World J Gastrointest Surg. 2016;8(1):65- 76. PMid:26843914

Gupta M, Goyal S, Singal R, Goyal R, Goyal SL, Mittal A. Gallstone ileus and jejunal perforation along with gangrenous bowel in a young patient: A case report. N Am J Med Sci. 2010;2(9):442-3. PMid:22558595

Ripollés T, Miguel-Dasit A, Errando J, Morote V, Gómez-Abril SA, Richart J. Gallstone ileus: Increased diagnostic sensitivity by combining plain film and ultrasound. Abdom Imaging. 2001;26(4):401-5. PMid:11441553

Bakhshi GD, Chincholkar RG, Agarwal JR, Gupta MR, Gokhe PS, Nadkarni AR. Gallstone ileus: Dilemma in the management. Clin Pract. 2017;7(3):117-9. PMid:28808520

Elabsi M, Amraoui M, Errougani A, Chkof MR. Diagnosis and treatment: Gallstone ileus. Dig Liver Dis. 2007;39(2):180-1. PMid:17208525

Inukai K. Gallstone ileus: A review. BMJ Open Gastroenterol. 2019;6(1):e000344. bmjgast-2019-000344 PMid:31875141

Apollos JR, Guest RV. Recurrent gallstone ileus due to a residual gallstone: A case report and literature review. Int J Surg Case Rep. 2015;13:12-4. PMid:26074485




How to Cite

Darmadi D, Ruslie RH, Samosir CT. Gallstone Ileus: A Case Report. Open Access Maced J Med Sci [Internet]. 2020 Jul. 30 [cited 2024 May 26];8(C):121-4. Available from:



Case Report in Internal Medicine


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