[A case of biliary ileus in a subject who had already undergone cholecystectomy]

A rare case of biliary ileus in an already cholecystectomized subject is reported. Apart from the rarity of the case, the failure to evidence a bilio-digestive fistula intraoperatively is pointed out and a trans-choledochal migration mechanism for the gallstone is hypothesised. After a short review of the main complications connected with this serious form of intestinal occlusion, stress is laid on the advisability of carrying out, especially in emergency situations, simple entero-lithotomy, confining more invasive surgery, such as the repair of the biliodigestive fistula or cholecystectomy to cases in which recurrent biliary pathology is evident.