[Clinical and imaging aspects of gallstone ileus. Experiences with 108 individual observations]

Cases of gallstone ileus (108) were analyzed retrospectively over 30 years. Even today, when laparoscopic cholecystectomy is done, the incidence of this rare disease remains the same. History, clinical and X-ray findings are non-specific. Aerobilia was seen in 17% of the patients. Since 1992 sonography has provided an exact diagnosis in 10 of 15 cases. In the triad of known gallstone, non-specific epigastric pain with assumed small intestinal obstruction, and impossible detection of a stone in the gallbladder, there is strong suspicion of a gallstone ileus. The evidence is given if the gallstone is seen in the bowels. Intraoperatively more than one stone was found in the intestines in 20%, and cholecystoduodenal fistulas were encountered in 83%. Other fistulas are rare. There has been no significant change in mortality for 30 years.