Barcelona Melden Darrell, Abdalla Sala
Medical Education Department, Ealing Hospital, London North West University Healthcare NHS Trust, London, UK
Department of General Surgery, Ealing Hospital, London North West University Healthcare NHS Trust, London, UK.
BMJ Case Rep. 2025 Jan 8;18(1):e263628. doi: 10.1136/bcr-2024-263628.
We present a case of a woman in her 70s who arrived in the emergency department with signs of small-bowel obstruction. CT scanning revealed acute cholecystitis with a cholecystoduodenal fistula, pneumobilia and small-bowel obstruction possibly secondary to gallstone ileus although no radio-opaque gallstones were seen. The patient underwent an emergency operation and intra-operative findings revealed mechanical small-bowel obstruction of the proximal jejunum where a 4×2 x 3 cm gallstone was impacted. A laparoscopic-assisted enterotomy was performed with stone extraction and primary closure. The patient made a full recovery. A planned laparoscopic cholecystectomy and repair of cholecystoduodenal fistula is scheduled on elective basis.
