Gallstone ileus

Discussion:

Large gallstones cause gallbladder distension with opposition of the gallbladder and duodenal walls. When there is a long-standing irritation between the two, fistula can form.  Once a small fistula forms, constant irritation from the gallstone causes its enlargement until the gallstone can escape.

Once the fistula has formed, gas can be demonstrated in the biliary tree and gallbladder.

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