One-stage Surgery in a Huge Gallstone Ileus Patient: A Case Report and Literature Review

Abstract Gallstone ileus is a rare complication of cholelithiasis, with an incidence of 0.5%. In this condition, a biliary stone enters into the bowel through a biliary-enteric fistula. This can occur in different conditions such as cholelithiasis and Mirizzi syndrome. Approximately 60% of biliary-enteric fistulas result in cholecystoduodenal fistulas. Typical symptoms of gallstone ileus include diffuse abdominal pain and vomiting, with an average symptom duration of 5 days before admission. This condition is usually diagnosed using abdominal computed tomography and standing abdominal plain films. Management typically involves enterolithotomy, cholecystectomy, and fistula closure, with the approach depending on the patient’s performance and the need for one- or two-stage surgery. Herein, we present a case of gallstone ileus with cholecystoduodenal fistula formation and typical symptoms, which was successfully managed with one-stage surgery.