Presentation
Abdominal distension, nausea, profuse vomiting; has not passed feces or gas for the past 6 days.
Patient Data
VP shunt along right chest and abdominal wall, its tip in the pelvis.
Tip of NGT in stomach.
The gallbladder is contracted and contains gas. Fistulous tract between the gallbladder and the duodenal bulb.
Dilated small bowel loops. Huge gallstone in small bowel loop in right lower abdomen, collapsed small bowel distal to it.
Moderate aortic valve calcification, coarse mitral annular calcification.
Photos of the resected segment of small bowel containing the gallstones and of the gallstones themselves.
Case Discussion
Several large gallstones passed from the gallbladder into the proximal duodenum through a fistula created between them and caused small bowel obstruction, i.e. gallstone ileus.
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