Epidemiology

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Etiology

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Pathophysiology

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Clinical features

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Diagnostics

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Treatment

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Complications

• Gallstone ileus: mechanical bowel obstruction due to obstructive gallstones
  • Pathophysiology: gallbladder perforation or Mirizzi syndrome → biliary-enteric fistula formation (most commonly cholecystoenteric fistula) between the inflamed gallbladder and bowel → gallstones passing down into bowel lumen
  • Sites of obstruction: terminal ileum, at ileocecal valve (most common)
  • Symptoms: distal bowel obstruction: features of mechanical bowel obstruction (abdominal pain and distention, nausea, vomiting)
  • Diagnosis is based on the Rigler triad: imaging findings of small bowel obstruction, gallstone (most commonly in iliac fossa), and pneumobilia.
    • Air can move up toward the biliary ducts through a cholecystoenteric fistula.