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Gallstone Ileus With Atypical Gastrointestinal Bleeding: A Case Report and Literature Review

Year: 2026

Type: article

Abstract: Gallstone ileus is a rare complication of cholelithiasis. Its diagnosis is challenging due to a nonspecific presentation and high morbidity and mortality related to age and comorbidities. An 87-year-old female with a history of hypertension presented with obstructive abdominal pain, hyporexia, and "coffee-ground" emesis. Upon admission, she showed hemodynamic instability [blood pressure (BP) 83/51 mmHg] and acute renal failure [Creatinine (Cr) 1.34 mg/dL]. Computed tomography revealed Rigler's triad, consisting of small bowel obstruction, neumobilia, and an ectopic gallstone. Exploratory laparotomy identified a stone impacted 140 cm from the Treitz ligament. A "milking" maneuver and simple enterolithotomy were performed, extracting a 2.5 cm gallstone. The patient had a favorable recovery and was discharged on the sixth postoperative day. Gallstone ileus should be suspected in geriatric patients with obstructive symptoms, even when presenting with atypical gastrointestinal bleeding. In extremely frail or hemodynamically unstable patients, simple enterolithotomy remains the gold standard to reduce surgical time and intraoperative complications.

Source: Cureus

DOI: 10.7759/cureus.109974

Authors: Armando Viramontes, Mario Alberto Munoz Flores, Carlos Javier Mares Jimenez, Eduardo Enrique Soto Ruiz, Jazmin Baca-Moreno

Institutions: Institute for Social Security and Services for State Workers, Mexican Social Security Institute

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: diamond

OpenAlex ID: W7162943828

FWCI:

Cites: 11

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