[Colonic ileus caused by a giant gallstone]

Area of Science:

• Gastroenterology
• Surgical Case Reports

Background:

• Gallstone ileus is a rare complication of cholelithiasis.
• Colonic impaction is an exceptionally uncommon presentation.

Observation:

• A 90-year-old male presented with symptoms of bowel obstruction.
• A large 6x8 cm gallstone was identified as the cause of the ileus.
• The gallstone was lodged in the sigmoid colon, originating from a gallbladder-to-colon fistula.

Findings:

• Surgical laparotomy successfully removed the impacted gallstone.
• The gallbladder-colon fistula was left untreated.
• The patient experienced an initial full recovery.

Implications:

• This case highlights the importance of considering gallstone ileus in elderly patients with bowel obstruction.
• Successful management of large gallstones causing colonic obstruction is possible.
• Delayed complications like choledocholithiasis can occur even after initial recovery.