[Determination of gallstone ileus using emergency gastroscopy]

It is reported on the diagnosis of a gallstone ileus in a 73-year-old female patient. In an otherwise quiescent anamnesis an increasing vomiting has been since 10 days. The X-ray examination of the stomach with visotrast 370 resulted in the suspicion of a pyloric stenosis. By means of emergency gastroscopy an independent disease of stomach and duodenum was excluded, but in the duodenal bulb 2 gallstones of the size of a hazel-nut and a kernel of the hazel-nut with references to a cholecystoduodenal fistula were established. In this case the emergency gastroscopy resulted in the indication to the immediate operation on account of gallstone ileus with previously unclear symptomatology of an ileus. Additionally a nearly hen's egg-sized stone was removed aborally 30 cm from Treitz's fascicle.