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Resident's Forum
November 17, 2008

Recurrent Gallstone Ileus: Third Time Is the Charm

Author Affiliations

Author Affiliations:Department of Surgery, Massachusetts General Hospital/Harvard Medical School, Boston.



Arch Surg. 2008;143(11):1118-1120. doi:10.1001/archsurg.143.11.1118

We report herein the case of a 57-year-old man who presented after the third occurrence of gallstone ileus. The patient underwent successful enterolithotomy, partial cholecystectomy, and repair of choledochoduodenal fistula. Although recurrent gallstone ileus is relatively rare, its occurrence is an indication for definitive management of the biliary-enteric fistula.

A 57-year-old man presented to the emergency department with a 1-day history of dull, midline abdominal pain, nausea, and dark brown emesis. He denied fever or chills. His last bowel movement was the morning of presentation, and since then he had not passed any flatus.