Gallstone Ileus: An Unusual Cause of Intestinal Obstruction

Gallstone ileus is a rare complication of gallstone disease, wherein a dislodged gallstone causes bowel obstruction by impaction of the intestines. Elderly patients and those with a history of gallstones are most commonly affected. Symptoms are usually vague and obscure, with patients reporting bloating, nausea and vomiting, early satiety, and constipation. To confirm the diagnosis, a contrast-enhanced computed tomography (CECT) scan is most commonly used, wherein Rigler's triad of small bowel distention, aerobilia, and an ectopic gallstone may be seen, which prompts further management. Treatment would depend on the clinical circumstances, with either a conservative or surgical approach, although the latter is preferred in cases of intestinal obstruction. We have described a case of this very phenomenon, intending to bring awareness to its innocuous clinical presentation due to its potential fatality.