Gallstone ileus: the importance of individualized management


  • Soulé-Martínez Christian Enrique Department of General Surgery, North Central Hospital of PEMEX, Mexico City, Mexico
  • Alfaro-Ponce David Department of General Surgery, Villahermosa Regional Hospital of PEMEX, Villahermosa, Mexico
  • Castellanos-Aguilar Leonel Department of General Surgery, North Central Hospital of PEMEX, Mexico City, Mexico
  • Jaimes-Durán Edwing Michel Department of General Surgery, North Central Hospital of PEMEX, Mexico City, Mexico
  • Banegas-Ruíz Rodrigo Department of Traumatology, Hand Surgery and Microsurgery, National Institute of Rehabilitation “Luis Guillermo Ibarra Ibarra, Mexico City, Mexico
  • Barajas-Colón Jose Angel Department of Angiology and Vascular Surgery, XXI Century National Medical Center, Mexico City, Mexico
  • Valderrama-Treviño Alan Issac Department of General Surgery, North Central Hospital of PEMEX, Mexico City, Mexico



Cholelithiasis, Gallstone ileus, Bowel obstruction, Cholecystoduodenal fistula


Gallstone ileus represents a complication of cholelithiasis, which in the literature has been reported as a rare cause of mechanical intestinal obstruction, however, the reported incidence is not so low, especially after 65 years of age. The formation of a bilioenteric fistula allows the passage of a large gallstone into the intestine, usually impacting the distal intestine. It is associated with a mortality that ranges between 12 and 27%. Treatment is surgical, although there is no consensus on which of the surgical techniques is the one of choice. We report the case of an 87-year-old male patient who was admitted to the emergency department with intestinal obstruction. He was diagnosed with gallstone ileus and was treated surgically with exploratory laparotomy, enterotomy with stone extraction, and primary closure. The evolution was favorable and without complications.


Laurenco S, Pereira AM, Reis J, Guimaraes M, Nora M. Gallstone Ileus: An Improbable Cause of Mechanical Small Bowel Obstruction. Cureus.2020;12(11):1-6.

Noah AO, Wadoodi A, Priest O. Gallstone ileus: a not-so-rare cause of bowel obstruction in the elderly. BMJ Case Rep. 2012:1-2.

Singh G, Merali N, Shirol S, Drymousis P, Singh S, Veeramootoo D. A case report and review of the literature of Bouveret, Syndrome. Ann R Coll Surg Engl. 2020;102:15-9.

Salazar-Jimenez MI, Alvarado-Duran J, Fermín-Contreras MR, Rivero-Yañez F, Lupian-Angulo AI, Herrera Gonzalez A. Revisión del manejo quirúrgico. Cir Cir. 2018;86:182-6.

Freeman MH, Mullen MG, Friel CM. The progression of cholelithiasis to gallstone ileus: do large gallstones warrant surgery? J Gastrointest Surg. 2016; 20(6):1278-80.

Dunphy L, Al-Shoek I. Gallstone ileus managed with enterolithotomy. BMJ Case Rep. 2019;12:1-4.

Aguilar-Espinosa F, Gálvez-Romero JL, Falfán-Moreno J, Guerrero-Martinez GA, Vargas-Solis F. Sangrado de tuno digestivo y delirium, resto en el diagnóstico del ileo biliar: reporte de un caso y revisión de bibliografía. Cir Cir. 2017;299:1-5

Pratas N, Salvador D, Costa CS. Gallstone ileus caused by a gallstone impacted at a cecum neoplasm. A case report. Int J Surg Case Rep. 2020;77:107-10.

Marcucci V, Diko S, Christian D. Gallstone ileus in a patent with amyotrophic lateral sclerosis: A case report. Int J Surg Case Rep. 2021;79:210-14.

Yang KJ, Chang CK. Bouveret Syndrome: A rare case of instance and treatment in a younger patient. Case Rep Gastroenterol. 2020:1-3.

Scuderi V, Adamo V, Naddeo M, Di Natale W, Boglione L, Cavalli S. Gallstone ileus: monocentryczna experience looking for the adequate approach. Updates Surg. 2018;70;503-11.

Mir S, Hussain Z, Davey A. Management and outcome of recurrent gallstone ileus: a systematic review. World J Gastroenterol. 2015;7:152-15

Rabie MA, Sokker A. Colecystolithotomy, a new approach to reduce recurrent gallstone ileus. Acute Med Surg. 2019;6:95-100.

Hussain J, Alrashed AM, Alkhadher T, Wood S, Behbedhadi AD, Termos S. Gall stone ileus: Unfamiliar cause of bowel obstruction. Case and literature review. Int J Surg Case Rep. 2018;49:44-50.

Halabi W, Kang C, Ketana N, Lafaro K, Nguyen V, Stamos M et al. Surgery for gallstone ileus. Ann Surg. 2014;259(2):329-35.

Hao J, Chong J, Jing-Gang M, Lie-Zhi W, Lei M, Kun-Peng W. Rare recurrent gallstone ileus: A case report. World J Clin Cases. 2020;8(10);2023-7.






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