[Ultrasound criteria of gallstone ileus]

During a 4-year period we treated four patients with gallstone ileus by enterotomy and extraction of the impacted concrement. Diagnosis was quickly established by abdominal ultrasound examination in all cases. Lacking visibility of the gallbladder in the clinical setting of ileus and subileus proved to be a sonographic clue of gallstone ileus and prompted a thorough search for the obturating gallstone which could definitely be demonstrated as an intraluminal semicircular reflex with strong echos and a sonic shadow in all patients. Thus, due to early diagnosis and timely surgical intervention, even in the absence of full-blown ileus, all of our elderly patients and those with a multitude of diseases still had a favorable outcome.