Work

Radiolucent gallstone ileus causing proximal small bowel obstruction: A case report

Year: 2025

Type: article

Abstract: Gallstone ileus occurs when gallbladder stones erode and become lodged in the small bowel, thereby causing obstruction. These stones usually impact the terminal ileum because of its narrow lumen; however, they can also be found in less common locations, as observed in our case. The presence of pneumobilia can indicate gallstone ileus even without visible radiopaque stones because not all gallstones are detectable on computed tomography (CT). A 74-year-old woman presented to the emergency department with severe right upper quadrant pain that started 1 week previously and became more aggressive associated with fever, leukocytosis, and vomiting. The pain was colicky, intermittent, and aggravated by movement but did not radiate. Further imaging was requested to investigate the cause of the pain, which revealed evidence of proximal small bowel obstruction due to radiolucent gallstone ileus. Radiolucent gallstone ileus is a rare but serious condition requiring prompt surgical intervention. The presence of pneumobilia can indicate gallstone ileus even when the stones are not visible on CT. Large stones can cause blockages in the proximal small bowel. The ability of radiological imaging to detect gallstones varies according to their composition.

Source: Radiology Case Reports

DOI: 10.1016/j.radcr.2025.02.002

Authors: Abdulmalek Alzahrani, Mohammad Alsayed, Jalal A. Zahhar, Saga Ali, Samira Alturkistany

Institutions: King Faisal Specialist Hospital & Research Centre, King Saud bin Abdulaziz University for Health Sciences

Language: English

Topic: Biliary and Gastrointestinal Fistulas

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $600