Biliary Ileus: A Case Report and Review of the Literature

Biliary ileus is a rare mechanical obstruction caused by the entrapment of biliary macrolithiasis in a portion of the digestive tract resulting from a bilio-digestive fistula. We report the case of an 88-year-old woman was admitted (Victor JOUSSELIN General Hospital, Dreux, France) with complaints of nausea, vomiting, abdominal pain and bloating. Physical examination, blood tests and radiological investigations revealed that the patient was suffering from acute mechanical bowel obstruction due to biliary ileus. A laparotomy was indicated and performed. The main procedure was an enterotomy with gallstone extraction followed by jejunal suturing. Biliary ileus is a rare condition more often seen in older women. The diagnosis is based on computed tomography (CT). Enterolithotomy without cholecystectomy (and the repair of the fistula) is the treatment of choice.