[Unusual case of biliary ileus]

The clinical and radiological picture observed in a female patient with cholelithiasis urgently hospitalised for abdominal occlusion is described. Radiological examination of the digestive tract disclosed a bilio apico-bulbar fistula and ectasis and hypotonia of the jejuno-ileal loops. A large calculus composed of calcium salts and cholesterine buried in a sigmoid loop was spontaneously passed by the patient during the examination. This resulted in regression of the symptoms of pain and occlusion. Cholangiocholecystography and examination of the digestive tract 3 months later showed a normal gallbladder picture, and disappearance of the fistula.