An unusual case of gallstone ileus with rare spontaneous resolution and literature review

TL;DR

A rare case of gallstone ileus in a 59-year-old woman resolved spontaneously without surgery, highlighting the potential for conservative management in select cases.

Contribution

This case report presents a rare instance of spontaneous resolution of gallstone ileus and advocates for conservative management in specific scenarios.

Findings

A 59-year-old female with gallstone ileus was managed conservatively as the stone migrated to the descending colon.

Conservative management may be a viable option if the gallstone progresses distally in select patients.

Repeat imaging and a multidisciplinary approach are crucial for successful outcomes in such cases.

Abstract

Gallstone ileus is a rare cause of mechanical bowel obstruction, typically affecting elderly patients with a history of gallstones. It results from the migration of a gallstone through a cholecystoenteric fistula into the bowel, most commonly lodging in the ileum. We report a case of a 59-year-old female who presented with small bowel obstruction caused by a 22 mm gallstone. During diagnostic laparoscopy, no obstructing stone was found, and subsequent imaging revealed its migration to the descending colon. The patient was successfully managed conservatively without surgical intervention. This case emphasizes the importance of considering gallstone ileus in elderly patients presenting with obstruction and demonstrates that conservative management may be an option in select cases, particularly when the stone progresses distally. Repeat imaging and a multidisciplinary approach are essential for optimal outcomes.

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