Unusual manifestations of gallstone migration into the gastrointestinal tract

Eighty-one cases of mechanical small bowel obstruction were seen at our hospital in the three year period 1978 to 1980. Four (5%) were due to gallstone ileus, three of them in women. All four patients were more than 75 years of age. Because most patients with biliary-enteric fistulas and gallstone ileus are elderly and in poor general condition, simple removal of the obstruction gallstone is usually adequate, but interval cholecystectomy is recommended in patients with a long life expectancy, because recurrence of calculi and symptoms increases with time.