The scout film from the CT shows 2 of the 3 components of the Rigler triad: pneumobilia and small bowel obstruction. The CT shows the third component: a gallstone at the site of obstruction. Chronic cholecystitis leads to a cholecystoduodenal fistula and migration of gallstone(s) into the small bowel where they may cause obstruction if large enough. It is important to avoid satisfaction of search and thoroughly examine the small bowel for any additional stones such that they can all be retrieved during surgery. A single stone was successfully retrieved in this case with an uneventful recovery.