Gallstone ileus in geriatric patients: a report of two cases

Abstract

Gallstone ileus is a mechanical obstruction of the small intestine caused by gallstone impaction. It accounts for 1% to 4% of all cases of mechanical obstruction. Previous acute cholecystitis results in development of a fistula between the gallbladder and the gastrointestinal tract. Diagnosing gallstone ileus is difficult as symptoms and signs are non-specific and most patients are elderly with multiple comorbidities. We report two cases of gallstone ileus in elderly patients. The first case is a 72-yearold man with multiple comorbidities who presented with vomiting, intermittent colicky right-sided abdominal pain, and inability to pass motion. He underwent enterolithotomy alone. The second case is a 73-year-old woman who presented with abdominal pain, distension, fever, and a fistulous communication between the gallbladder and the duodenum. She underwent enterolithotomy, partial cholecystectomy, and closure of the fistula.