[Recurrent calculus ileus of the small bowel. A diagnostic problem]

Occlusion of the lumen by gallstones must be considered a rare cause of small bowel ileus; diagnosis and clinical symptoms have only sporadically been reported. The present paper shows that, in addition to gallstones, coproliths may also cause small bowel ileus, giving rise to identical clinical symptoms. For this reason, pre-operative diagnostic work-up should differentiate concretions in gallbladder and small bowel with respect to size, shape, consistency and X-ray contrast. If the stone proves to be a coprolith, the stenotic segment of bowel should be resected to prevent recurrences, while in the case of a gallstone, its manual manipulation across Bauhin's valve into the colon suffices.