Presentation
Sudden onset of left-sided abdominal pain. Vomiting and guarding.
Patient Data
Age: 85 years
Gender: Male
From the case:
Gallstone ileus
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Pneumobilia, collapsed gallbladder with fistulous tract filled with air between galbladder and first part of duodenum consistent with cholecystoduodenal fistula.
Small bowel obstruction and large stone at the jujenum.
Case Discussion
Previously there was a 3.7 cm partially calcified gallstone within a distended gallbladder. This is now seen within the small bowel causing obstruction with distention of the proximal small bowel and stomach distention. Pneumobilia also present. Example of Rigler triad.
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