Spontaneous resolution (and other rarities) of gallstone ileus.

摘要

A 55-year-old male known to have cholelithiasis recently presented with 2 days of severe epigastric pain, bloating and vomiting. He was systemically well. The scarless abdomen with reducible bilateral inguinal hernias was distended with reduced bowel sounds. Blood tests were relatively normal. Plain X-ray revealed small bowel obstruction (SBO) and pneumobilia. Abdominal Computed Tomography performed prior to referral revealed a cholecystoduodenal fistula and SBO resulting from a 2.8-cm x 2.2-cm gallstone in the terminal ileum. At laparoscopy, the stone could not be identified, but at minilaparotomy, it was palpable in the ascending colon. The abdomen was closed. The patient's bowels worked on day 1, and he went home on day 4. He was well at 3 months follow-up but was not aware of having passed a gallstone per rectum.