Gallstone ileus secondary to cholecystoduodenostomy causing mechanical duodenal obstruction in a cat

A 9-year-old neutered male domestic shorthair cat was presented for anorexia and lethargy with a 2-day history of ptyalism and dysorexia. The cat had undergone a cholecystoduodenostomy 8 years before presentation and had suffered from episodes of clinical cholangitis ever since. Abdominal ultrasound revealed duodenal obstruction. Two stones were surgically removed, subjected to spectrophotometric examination and identified as choleliths. Clinical improvement was noted postoperatively, and 12 months after surgery the cat was doing well and had no further digestive problems.

This case report describes an original case of gallstone ileus, a complication which, to our knowledge, has never been described after cholecystoduodenostomy in cats. A parallel can be drawn with Bouveret's syndrome in humans, which is characterised by duodenal or gastric gallstone ileus secondary to an acquired bilioenteric fistula.