Presentation
Abdominal pain, nausea and vomiting for 3 days
Patient Data
Age: 65 years
Gender: Female
From the case:
Gallstone ileus
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CT study shows the classic Rigler triad of pneumobilia, small bowel obstruction, ectopic gallstone with associated cholecystoduodenal fistula.
Case Discussion
Gallstone ileus occurs when a large gallbladder stone erodes into the duodenum via a fistula, eventually obstructing the ileal lumen usually some centimeters proximal to the ileocecal junction.
Classical findings: small bowel obstruction, gas in the biliary tree and large ectopic gallstone (Rigler triad). Other findings: collapsed gallbladder, gas in the gallbladder.
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