Gallstone Ileus: A Rare Incidental Gallstone Migration Seen on CT in a Patient With Traumatic Splenic Laceration

Gallstone ileus, a rare but severe complication of cholelithiasis, causes bowel obstruction and is typically associated with high morbidity and mortality. Here, we present the case of a 76-year-old male who initially presented with left upper quadrant abdominal pain after a ground-level fall, with the incidental finding of cholelithiasis. Over subsequent days, the patient developed symptoms of small bowel obstruction, and further CT imaging showed a new-onset gallstone ileus. Exploratory laparotomy confirmed the obstruction within the distal jejunum, and a large gallstone was successfully extracted. This case highlights the importance of considering gallstone ileus in patients with atypical presentation and underscores the potentially critical role of CT imaging in diagnosing and tracking gallstone movement. Increased awareness and understanding among clinicians, particularly in trauma settings, are essential for timely intervention and improved patient outcomes.