Gall Stone Ileus: An Uncommon Cause of Small Bowel Obstruction and Bowel Ischemia

Abstract

Gall stone ileus is an uncommon cause of small bowel obstruction, which accounts for 1-4% of mechanical small bowel obstruction. Due to its elusive nature, the diagnosis is frequently delayed, resulting in high morbidity and mortality rates. plain abdominal X-ray films are not adequate for diagnosing gallstone ileus. Surgery is the mainstay treatment for gall stone ileus. The best surgical approach that includes one-staged versus a two-staged approach and open versus laparoscopic approach, remains controversial. The main aim of emergency surgery is to relieve the intestinal obstruction. We report a case of a 74-year-old female who presented to surgery emergency with a case of gall stone ileus causing small bowel obstruction. In our case, we performed exploratory laparotomy followed by enterotomy with stone extraction alone due to dense adhesion around gall bladder and unstable general condition. Enterotomy with stone extraction alone remains the most common surgical method because of its low incidence of complications.