Spontaneous resolution of a gallstone ileus

Area of Science:

• Gastroenterology
• Surgical Complications

Background:

• Gallstone ileus is an infrequent complication of gallstones (cholelithiasis).
• It commonly involves an internal biliary fistula, necessitating surgical management.
• Standard surgical treatment includes enterolithotomy and fistula closure.

Purpose of the Study:

• To report a rare case of gallstone ileus with a cholecystoduodenal fistula.
• To document the outcome of conservative management in a patient who refused surgery.

Main Methods:

• A 66-year-old female presented with symptoms of abdominal pain.
• Computed tomography (CT) confirmed gallstone ileus and a cholecystoduodenal fistula.
• The patient opted for non-surgical management.

Main Results:

• The patient experienced spontaneous resolution of the intestinal obstruction.
• Gallstones were passed spontaneously, resolving the ileus.
• No surgical intervention was performed.

Conclusions:

• While surgery is the standard for gallstone ileus, this case demonstrates that spontaneous resolution is possible.
• Conservative management may be an option in select cases of gallstone ileus with fistula, albeit rare.