[Gallstone ileus. Our experience]

Five patients were operated on for gallstone ileus over a 10-year period. Plain abdominal radiograms performed at admission were diagnostic in only 2 patients while other procedures such as ultrasonography and gastroduodenoscopy were required in 2 patients. Obstructing stones were located in the terminal ileum in three patients and in the duodenum in two. A one-stage procedure consisting in the removal of the impacted stone, fistula repair, and cholecystectomy was performed in three patients, two of whom died. Removal of impacted stones was the only surgical treatment in the remaining two patients, with no mortality. The Authors conclude that enterolithotomy alone should be the standard procedure for gallstone ileus. The repair of cholecysto-enteric fistula should be scheduled on elective basis and only if there are continuing or recurrent symptoms.