Gallstone ileus presenting in an elderly patient: A case report.

Area of Science:

• Gastroenterology
• Surgical Case Reports

Background:

• Biliary ileus is a rare cause of mechanical intestinal obstruction.
• It occurs when a gallstone enters the gastrointestinal tract via a bilioenteric fistula.
• The condition is associated with high morbidity and mortality, particularly in the elderly.

Observation:

• A 94-year-old female presented with symptoms of intestinal obstruction.
• Computed tomography revealed Rigler's triad, confirming biliary ileus.
• Exploratory laparotomy identified and removed three gallstones from the small intestine.

Findings:

• Biliary ileus often presents with nonspecific symptoms, posing a diagnostic challenge.
• Rigler's triad (pneumobilia, intestinal obstruction, ectopic gallstone) is diagnostic but not always visible on imaging.
• Surgical intervention is the standard of care for resolving the obstruction.

Implications:

• This case highlights the importance of considering biliary ileus in the differential diagnosis of intestinal obstruction in elderly patients.
• Early surgical intervention is crucial for favorable outcomes and preventing severe complications.
• Prompt diagnosis and management are essential for improving patient survival rates.