Gallstone Ileus: A Definitive Guide to Diagnosis and Management of a Rare Cause of Small Bowel Obstruction
Introduction Gallstone ileus stands as a fascinating yet treacherous entity in general surgery and emergency medicine. While it accounts for a mere 1-4% of all mechanical small bowel obstructions, its prevalence dramatically increases to 25% in the population over 65, making it a critical diagnosis to consider in elderly patients presenting with obstructive symptoms . This condition is not a true "ileus" in the paralytic sense but rather a mechanical obstruction caused by an ectopic gallstone that has migrated into the bowel lumen through a fistula. The diagnostic journey can be complex, often delayed by nonspecific symptoms, leading to significant morbidity and mortality. This column provides a world-class, in-depth exploration of gallstone ileus , using a compelling case study to illustrate the clinical presentation, key imaging features, and modern management strategies. We will delve into the pathophysiology, epidemiology, and treatment protocols, offering a definitive ...